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Determination of 6-Thioguanine and 6-Methylmercaptopurine Metabolites in Renal Transplantation Recipients and Patients With Glomerulonephritis Treated With Azathioprine

 

作者: Maria Chrzanowska,   Maciej Krzymański,  

 

期刊: Therapeutic Drug Monitoring  (OVID Available online 1999)
卷期: Volume 21, issue 2  

页码: 231-237

 

ISSN:0163-4356

 

年代: 1999

 

出版商: OVID

 

关键词: Azathioprine;6-Thioguanine nucleotides;6-Methylmercaptopurine metabolites;Allopurinol;Renal transplantation;Glomerulonephritis

 

数据来源: OVID

 

摘要:

The metabolism of azathioprine (AZA) was studied by monitoring the concentrations of red blood cell (RBC) 6-thioguanine nucleotides (6-TGN) and of 6-methylmercaptopurine metabolites (6-mMP) in 27 renal transplantation recipients and in 10 patient subjects with glomerulonephritis (GN). Concentrations of 6-TGNs and 6-mMP metabolites were measured using high-performance liquid chromatography (HPLC). Six patients from the group of renal transplantation recipients were also administered allopurinol. Median values of RBC 6-TGN and of 6-mMP metabolites concentrations in 21 renal transplantation recipients (without allopurinol) were 122 pmol / 8×108RBCs (range, <60-298) and 280 pmol / 8×108RBC (range, <150-1330), respectively; there was no correlation between concentrations of 6-TGN and of 6-mMP metabolites. The group of 21 renal transplantation recipients received different AZA doses (100 or 50 mg/d) related to clinical symptoms of AZA intolerance. The median values of 6-TGN concentrations in these subgroups were 131 and 122 pmol / 8×108RBCs and were not significantly different. Median values of 6-TGN concentrations in patients given allopurinol were significantly higher, despite AZA dose reduction, compared with the group without allopurinol and were equal to 363 and 122 pmol / 8×108RBC,p< 0.004, respectively. No significant differences were found between the concentrations of 6-mMP metabolites in either group. In the group of renal transplantation recipients, a significant correlation between white blood cell (WBC) count and 6-TGN concentration was established (rs= -0.59,p< 0.005). In the group of GN patients, the median values of 6-TGN and of 6-mMP metabolites concentrations were 108 pmol / 8×108RBCs (range, 0-297) and 420 pmol / 8×108RBC (range, 0-1440), respectively. There were no significant correlations between either the WBC count and 6-TGN concentrations or between 6-TGN concentrations and 6-mMP metabolites. We expect the results of our study to provide indications for better individualization of AZA therapy.

 



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