Monitoring Concentration and Pharmacodynamic Effects of Tacrolimus in Peripheral Blood Lymphocytes of Kidney Transplant Recipients

NCT ID: NCT03425071

Last Updated: 2018-02-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

45 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-03-08

Study Completion Date

2018-12-31

Brief Summary

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Therapeutic drug monitoring (TDM) of immunosuppressive drugs is used to improve the immunosuppressive effect while minimizing the toxicity related to exposition to high serum levels. Although TDM is widely used in clinical practice, a significant number of kidney transplant recipients have acute allograft rejection in the first year after transplantation. To improve the use of immunosuppressive drugs, new approaches of TDM have been developed. Monitoring drug concentrations at lymphocytes of peripheral blood is considering promising because it indicates the availability of the drug directly in the target sites of immunosuppression. The present study intends to establish the concentration profile of tacrolimus in the peripheral blood in parallel with the concentration profile inside T and B lymphocytes of peripheral blood of kidney transplant recipients, and correlates them with the expected pharmacological effects. The pharmacological effects of tacrolimus in calcineurin dependent and calcineurin independent (mitogen-activated protein kinase (MAPK) dependent) activation pathways will be assessed by measuring activated nuclear factor of activated T cells (NFAT) and p38, respectively, by flow cytometry. The expression of interleukin (IL) - 2 and IL-10 by T and B lymphocytes, respectively, will be also used to monitoring the pharmacodynamic effects of tacrolimus.

Detailed Description

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Conditions

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Kidney Transplantation Rejection

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Healthy volunteers

Healthy volunteers - subjects without exposure to tacrolimus. Blood samples from these subjects will be used in "in vitro" experiments.

No interventions assigned to this group

kidney transplant (KTx) months 1-2

Kidney transplant recipients recruited during the months 1 to 2 of follow up after kidney transplantation surgery. These are subjects expected to be exposed to high blood levels of tacrolimus. Blood samples from these subjects will be used in "ex vivo" experiments.

No interventions assigned to this group

KTx months 4-5

Kidney transplant recipients recruited during the months 4 to 5 of follow up after kidney transplantation surgery. These are subjects expected to be exposed to standard blood levels of tacrolimus. Blood samples from these subjects will be used in "ex vivo" experiments.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Kidney transplant recipients with a well functioning graft (serum creatinine ≤ 2,0 mg/dL at inclusion)
* Must be on tacrolimus therapy
* Must be on short term follow up time (1 to 5 months) after surgery

Exclusion Criteria

* A concomitant second solid organ transplant
* Immunosuppression not containing tacrolimus
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Maria da Luz Fernandes

UNKNOWN

Sponsor Role collaborator

Paschoalina Romano

UNKNOWN

Sponsor Role collaborator

Persio de Almeida Rezende Ebner

UNKNOWN

Sponsor Role collaborator

Nairo Massakazu Sumita

UNKNOWN

Sponsor Role collaborator

Veronica Porto Carreiro de Vasconcelos Coelho

UNKNOWN

Sponsor Role collaborator

Fabiana Agena

UNKNOWN

Sponsor Role collaborator

Elias David Neto

UNKNOWN

Sponsor Role collaborator

Nelson Zocoler Galante

UNKNOWN

Sponsor Role collaborator

University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nelson Z Galante, PhD

Role: PRINCIPAL_INVESTIGATOR

Kidney Transplantation Service - University of Sao Paulo

Locations

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Hospital das Clínicas - University of Sao Paulo

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Fabiana Agena, PhD

Role: CONTACT

+551126618089

Facility Contacts

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Nelson Z Galante, PhD

Role: primary

+551126618089

Fabiana Agena, PhD

Role: backup

+551126618089

References

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Romano P, da Luz Fernandes M, de Almeida Rezende Ebner P, Duarte de Oliveira N, Mitsue Okuda L, Agena F, Mendes ME, Massakazu Sumita N, Coelho V, David-Neto E, Zocoler Galante N. UPLC-MS/MS assay validation for tacrolimus quantitative determination in peripheral blood T CD4+ and B CD19+ lymphocytes. J Pharm Biomed Anal. 2018 Apr 15;152:306-314. doi: 10.1016/j.jpba.2018.01.002. Epub 2018 Jan 5.

Reference Type RESULT
PMID: 29471254 (View on PubMed)

Other Identifiers

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CAAE 41558915900000068

Identifier Type: -

Identifier Source: org_study_id

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