Cinvestav develops a new model to establish correct dosage of immunosuppressants using mathematical models. Researchers hope to improve transplant success
By Agencia de Investigación y Desarrollo
Given that 10.5 percent of patients who receive a transplant reject the new organ, researchers at the Center of Research and Advanced Studies of the National Polytechnic Institute (Cinvestav) are working to design a process to prevent this problem. It centers on learning which type of proteins (enzymes) metabolize the drugs in each patient. Aided by a mathematical model, this would allow doctors to establish the exact dose of immunosuppressive drugs required by an individual transplant patient.
This method will allow doctors to establish an effective drug treatment regimen at the beginning of the transplant process, saving time and decreasing rejection rates, increasing quality of life, allowing more patients to survive, and optimizing the health system, said Gilberto Castañeda Hernández from the Department of Pharmacology.
According to the researcher, the enzymes that process the drugs have various grades of activity, so the immunosuppressant can be eliminated slowly or rapidly. Hence, it is necessary to find out, using genetic studies, what kind of proteins each person has to determine the correct dosage of the drug.
Studies are being carried out to create a mathematical algorithm that will indicate for each person, based on genetics, size, age, current medication and time since the transplant, what the dosage of immunosuppressive drug should be.
Currently, the quantity of drug to be administrated is determined by trial and error; however, this process takes time and can give rise to complications that can result in rejection of the transplanted organ.
“For example, the dosage of the drug Nifedipine that is used in Germany is not right for Mexicans, because it gives them headaches, tachycardia and vasodilation, among other problems,” said Castañeda Hernández.
The challenge will be to identify the patients who quickly metabolize immunosuppressives such as Tacrolimus and Ciclosporin. “In Mexico both exist, and their dosage is not the same as that used in Europe or the United States. We have to find our own variations based on genetics,” he added.
In Mexico, children especially, may benefit from this new method of treatment. Because they are still developing and their metabolism rates differ from those of adults, these analytical tools would have better results, said Castañeda Hernández.