The influence of Proinflammatory Cytokines on voriconazole trough concentration in patients with different forms of hematologic disorders

dc.contributor.authorMafuru, Magesa
dc.date.accessioned2022-01-26T10:42:36Z
dc.date.available2022-01-26T10:42:36Z
dc.date.issued2019
dc.description.abstractEven though multiple factors are involved in the high fluctuation of voriconazole (VCZ) plasma concentration, little is known regarding the influence of proinflammatory cytokines on VCZ concentration. The aim of this study was to investigate the influence of proinflammatory cytokines, namely, interleukin (IL)-1β, IL-6, IL-18, interferon-γ, tumor necrosis factor-α, and transforming growth factor (TGF)-β1 on VCZ trough concentration (VCZ-Cmin) in Chinese patients with different forms of hematologic disorders. A total of 250 plasma samples from 113 patients were analyzed for VCZ-Cmin and proinflammatory cytokines using a validated liquid chromatography–tandem mass spectrometry and enzyme-linked immunosorbent assay methods, respectively. Patient demographics and clinical characteristics were obtained from hospital records. VCZ-Cmin was significantly correlated with IL-18 in acute myeloid leukemia (r = 0.456; P ˂ .0001), acute lymphoblastic leukemia (r = 0.317; P = .019), and chronic myeloid leukemia (r = 0.737; P = .004) while VCZ-Cmin and TGF-β1 were correlated (r = 0.436; P ˂ .001) in acute myeloid leukemia patients only. VCZ-Cmin at different concentration range showed significant inhibitory effect of IL-6. A backward multiple linear regression model revealed patient age (coefficient [β] = 0.025; P = .04), gamma-glutamyl transferase (β = 0.003; P = .023), IL-6 (β = –0.001; P = .024), proton pump inhibitor coadministration (β = 1.518; P = .002), and cytochrome P450 (CYP) 2C19 polymorphism as predictors of VCZ-Cmin; however, these factors explained only 29% of VCZ-Cmin variation. In conclusion, IL-18 and TGF-β1 have correlation with VCZ-Cmin in Chinese patients with leukemia. Apparently, VCZ may have an inhibitory effect on IL-6 levels. Furthermore, patient age, gamma-glutamyl transferase, IL-6, PPI coadministration, and cytochrome P450 2C19 polymormorphism partially predicted the VCZ-Cmin. Therapeutic drug monitoring of VCZ in Chinese patients is highlyen_US
dc.identifier.citationMafuru, M., Wu, S., He, S., Lu, X., Huang, J. and Jiang, H., 2019. The influence of proinflammatory cytokines on voriconazole trough concentration in patients with different forms of hematologic disorders. The Journal of Clinical Pharmacology, 59(10), pp.1340-1350.en_US
dc.identifier.other/doi.org/10.1002/jcph.1422
dc.identifier.urihttp://hdl.handle.net/123456789/875
dc.language.isoenen_US
dc.publisherThe Journal of Clinical Pharmacologyen_US
dc.subjectVoriconazoleen_US
dc.subjectHematologic disordersen_US
dc.subjectPlasma concentrationen_US
dc.titleThe influence of Proinflammatory Cytokines on voriconazole trough concentration in patients with different forms of hematologic disordersen_US
dc.typeArticleen_US

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