Cyclosporine Transporter Pharmacogenomic Effect in Transplantation: An Updated Systematic Review

Muhannad Alanazi and Gomaa Mostafa-Hedeab

Cyclosporine (CsA) is commonly used in organ transplantation based on its immunosuppressant activity. Monitoring CsA fluctuation in the blood level is important as it belongs to drugs with narrow safety margin windows. Its low level may result in loss of immunosuppressant activity leading to rejection. In contrast, a high CsA level may result in CsA-related adverse effects. The CsA absorption is controlled mainly by ABCB1 and ABCB2 transporters. The current study aims to investigate the gene controlling CsA absorption among transplanted patients. A literature review was conducted from January, 2000 to November, 2024 using Scopus, Embase, as well as PubMed bibliography. The research focuses on cyclosporine, transplantation, pharmacogenetics and pharmacogenomics. The current research items were met by 482 which were subjected to the exclusion of duplication or unfit research papers that resulted in 48 final research papers, which were then analyzed. Hence, found a strong association between some ABCB1 gene polymorphisms and CsA blood level, while some results nullify that. These findings necessitate the need for a genome-wide association study with multi-centers with different ethnicities for better understanding and accurate conclusions of the CsA dosing based on genetic variability.

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