Influence of Polymorphisms on Mycophenolate Mofetil - Induced Diarrhoea in Renal Transplanted Children

P. Lancia, T. DeBeaumais, C. Dossier, Baudouin, T. Ulinski, G. Deschênes, É. Jacqz-Aigrain
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Abstract

Purpose: The objective of this study was to investigate the factors involved in mycophenolate mofetil  (MMF) disposition on the risk of diarrhoea in renal transplanted children. Methods: Patients’ characteristics, immunosuppression and polymorphisms of UGT1A8, UGT1A9, UGT2B7, ABCC2, IMPDH1, and IMPDH2 genes were explored. Statistical analyses were performed using logistic regression. Results: Eighty three renal transplanted patients were included and 28/83  (33%) developed diarrhoea requiring MMF discontinuation or switched to the enteric-coated formulation EC-MPS during follow-up. In the multivariate analysis, the risk of diarrhoea was significantly higher in ABCC2 -24CC wild-type patients carrying IMPDH2 IVS7 + 10 T>C variant. Conclusion: IMPDH2  (IVS7+10T>C) and ABCC2  (c.-24C>T) are biomarkers associated with diarrhoea in children treated with MMF.
多态对移植肾儿童霉酚酸酯所致腹泻的影响
目的:本研究的目的是探讨霉酚酸酯(MMF)处置对肾移植儿童腹泻风险的影响因素。方法:探讨患者UGT1A8、UGT1A9、UGT2B7、ABCC2、IMPDH1、IMPDH2基因的特征、免疫抑制及多态性。采用逻辑回归进行统计分析。结果:纳入83例肾移植患者,其中28/83(33%)在随访期间出现腹泻,需要停用MMF或改用肠溶制剂EC-MPS。在多因素分析中,携带IMPDH2 IVS7 + 10t >C变异的ABCC2 -24CC野生型患者发生腹泻的风险明显更高。结论:IMPDH2 (IVS7+10T>C)和ABCC2 (C - 24c >T)是与MMF治疗儿童腹泻相关的生物标志物。
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