Effect of UGT polymorphisms on pharmacokinetics and adverse reactions of mycophenolic acid in kidney transplant patients

Pharmacogenomics. 2021 Oct;22(15):1019-1040. doi: 10.2217/pgs-2021-0087. Epub 2021 Sep 28.

Abstract

Mycophenolic acid (MPA) is a common immunosuppressive drug for kidney transplantation patients, and is characterized by a narrow therapeutic index and significant individual variability. UGTs are the main enzymes responsible for the metabolism of MPA. Although, many studies have focused on the relationship between UGT polymorphisms and pharmacokinetics and adverse reactions of MPA, the conclusion are controversial. We reviewed the relevant literature and summarized the significant influences of UGT polymorphisms, such as UGT1A8 (rs1042597, rs17863762), UGT1A9 (rs72551330, rs6714486, rs17868320, rs2741045, rs2741045) and UGT2B7 (rs7438135, rs7439366, rs7662029), on the pharmacokinetics of MPA and its metabolites and adverse reactions. The review provides a reference for guiding the individualized administration of MPA and reducing adverse reactions to MPA.

Keywords: UGT polymorphism; adverse reactions; kidney transplantation; metabolites; mycophenolic acid; pharmacokinetics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Glucuronosyltransferase / genetics*
  • Glucuronosyltransferase / metabolism
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / pharmacokinetics*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / methods*
  • Mycophenolic Acid / adverse effects*
  • Mycophenolic Acid / pharmacokinetics*
  • Mycophenolic Acid / therapeutic use
  • Polymorphism, Genetic / genetics
  • Polymorphism, Single Nucleotide
  • Transplant Recipients

Substances

  • Immunosuppressive Agents
  • Glucuronosyltransferase
  • Mycophenolic Acid