PXR C24381A基因多态性对肾移植患者他克莫司血药浓度影响的Meta分析OA

Objective To systematically evaluate the effect of pregnane X receptor(PXR)C24381A gene polymorphism on tacrolimus(TAC)blood concentration in renal transplant recipients.Methods A computer-based search was conducted to identify related studies for effect of PXR C24381A gene polymorphism on TAC blood concentration in renal transplant recipients were retrieved from Embase,PubMed,the Cochrane Library,SinoMed,WanFang and CNKI databases from the establishment of the database to January 8,2024.The STREGA tool was used to evaluate the quality of the included studies,and RevMan 5.4 software was used for Meta-analysis.Results A total of seven studies were included,among which five were in Chinese and two in English,involving 1 218 patients,predominantly Asian populations(1 068 cases).The results of Meta-analysis showed that the 5-year postoperative TAC blood concentration/dose ratio(C/D)in patients with CC genotype was significantly lower than that in patients with AA genotype[MD=-0.58,95%CI(-0.88,-0.29),P=0.000 1].There were no statistically significant differences in TAC C/D between the following groups:CC genotype vs.CA genotype[MD=0.05,95%CI(-0.25,0.35),P=0.75],CA genotype vs.AA genotype[MD=-0.03,95%CI(-0.16,0.10),P=0.62],and CC+CA genotype vs.AA genotype[MD=-0.09,95%CI(-0.26,0.08),P=0.29].Conclusion Compared with the AA genotype,renal transplant recipients with CC genotype of PXR C24381A gene have a significantly lower 5-year postoperativeTAC C/D.The results of this study can provide evidence-based reference for the rational clinical application of TAC.