CYP3A5 and CYP3A7 genetic polymorphisms affect tacrolimus concentration in pediatric patients with nephrotic range proteinuria

  • Hongxia Liu
  • Qinxia Xu
  • Wenyan Huang
  • Qi Zhao
  • Zhihu Jiang
  • Xinyu Kuang
  • Zhiling Li
  • Huajun SunEmail author
  • Xiaoyan QiuEmail author



The purpose of this study was to investigate the potential impact of CYP3A4, CYP3A5, and CYP3A7 polymorphisms on the concentration and efficacy of tacrolimus in a cohort of pediatric patients with nephrotic range proteinuria.


Genetic variants including CYP3A5*3 (rs776746), CYP3A4*1G (rs2242480), rs4646437, and CYP3A7 rs2257401 and rs10211 were detected in 70 pediatric patients with nephrotic range proteinuria. The relationships of dose-adjusted trough concentration (C0) of tacrolimus with corresponding genotypes were investigated.


The tacrolimus concentration in patients without CYP3A5*3 A allele was 94% higher than those with A allele (90.7 vs 54.2, P = 0.00006). The CYP3A7 rs2257401 was also associated with the concentration of tacrolimus. The C allele carriers had an obviously lower C0 than the non-carriers (62.4 vs 90.7, P = 0.001). In addition, there were significant differences in tacrolimus concentration among CYP3A7 rs10211 G carriers and non-carriers; the latter had an almost twofold C0 of the former (101.8 vs 59.6, P = 0.0004).


Our study demonstrated the associations between CYP3A5*3, CYP3A7 rs2257401 and rs10211, and tacrolimus concentration in pediatric patients with nephrotic range proteinuria. Children with CYP3A5*3 A, CYP3A7 rs2257401 C, and rs10211 G alleles might need a higher dose of tacrolimus.


CYP3A5 CYP3A7 Polymorphisms Tacrolimus Pediatric patients Nephrotic range proteinuria 


Author’s contribution

Hongxia Liu and Qinxia Xu contributed equally to this article. Xiaoyan Qiu and Huajun Sun conceived the study. Xiaoyan Qiu, Qinxia Xu, and Hongxia Liu participated in the research design. Hongxia Liu, Xinyu Kuang, Wenyan Huang, and Qi Zhao contributed to the acquisition of the patients’ data. Zhihu Jiang and Zhiling Li performed the CYP3A5*3 genotyping. Qinxia Xu performed the research and analyzed the data. Xiaoyan Qiu and Qinxia Xu drafted. All the authors revised the manuscript.

Funding information

Hongxia Liu had financial support from the Shanghai Municipal Commission of Health and Family Planning (No. 20164Y0122). Dr. Xiaoyan Qiu had support from the Shanghai “Rising Stars of Medical Talent” Youth Development Program-Clinical Pharmacist Program, National Natural Science Foundation of China (No. 81302854), and Natural Science Foundation of Shanghai (No. 13ZR1405200).

Compliance with ethical standards

The study was performed in accordance with the Declaration of Helsinki and its amendments. Protocols were approved by the Ethics Committee of Shanghai Children’s Hospital and written informed consents were obtained from all subjects.

Conflict of interest

The authors declare that they have no conflict of interest.

Animal studies

This article does not contain any studies with animals performed by any of the authors.

Supplementary material

228_2019_2726_MOESM1_ESM.docx (14 kb)
ESM 1 (DOCX 13.9 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hongxia Liu
    • 1
  • Qinxia Xu
    • 2
  • Wenyan Huang
    • 3
  • Qi Zhao
    • 4
  • Zhihu Jiang
    • 1
  • Xinyu Kuang
    • 3
  • Zhiling Li
    • 1
  • Huajun Sun
    • 1
    Email author
  • Xiaoyan Qiu
    • 5
    Email author
  1. 1.Department of Pharmacy, Shanghai Children’s HospitalShanghai Jiao Tong UniversityShanghaiChina
  2. 2.Department of Pharmacy, Zhongshan HospitalFudan UniversityShanghaiChina
  3. 3.Department of Nephrology and Rheumatology, Shanghai Children’s HospitalShanghai Jiao Tong UniversityShanghaiChina
  4. 4.College of PharmacyFudan UniversityShanghaiChina
  5. 5.Department of Pharmacy, Huashan HospitalFudan UniversityShanghaiChina

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