{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:26:14Z","timestamp":1779269174874,"version":"3.51.4"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Calcineurin inhibitors (CNI) have a small therapeutic window, and drug monitoring is required. Pharmacokinetic monitoring does not correlate sufficiently with clinical outcome. Therefore, the expression of nuclear factor of activated T cells (NFAT)\u2010regulated genes in the peripheral blood has been suggested as a potentially useful immune monitoring tool to optimize CNI therapy. NFAT\u2010regulated gene expression (RGE) was evaluated in renal allograft recipients as predictive biomarker to detect patients at risk of acute rejection or infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>NFAT\u2010RGE (interleukin\u20102, interferon\u2010\u03b3, granular\u2010macrophage colony\u2010stimulating factor) was evaluated by quantitative real\u2010time polymerase chain reaction in whole blood samples at day 7, day 14, month 1, 3, and 6 after transplantation in 64 de novo renal allograft recipients from 3 European centres. Immunosuppression consisted of tacrolimus (Tac), mycophenolic acid, and corticosteroids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tac concentrations (C0 and C1.5) correlated inversely with NFAT\u2010RGE (<jats:italic>P\u2009&lt;<\/jats:italic>\u00a0.01). NFAT\u2010RGE showed a high interindividual variability (1\u201361%). Patients with high residual gene expression (NFAT\u2010RGE\u2009\u226530%) were at the increased risk of acute rejection in the following months (35 <jats:italic>vs<\/jats:italic>. 5%, <jats:italic>P\u2009=<\/jats:italic>\u00a0.02), whereas patients with low residual gene expression (NFAT\u2010RGE\u2009&lt;30%) showed a higher incidence of viral complications, especially cytomegalovirus and BK virus replication (52.5 <jats:italic>vs<\/jats:italic>. 10%, <jats:italic>P\u2009=<\/jats:italic>\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NFAT\u2010RGE was confirmed as a potential noninvasive early predictive biomarker in the immediate post\u2010transplant period to detect patients at risk of acute rejection and infectious complications in Tac\u2010treated renal allograft recipients. Monitoring of NFAT\u2010RGE may provide additional useful information for physicians to achieve individualized Tac treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.14794","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T13:54:29Z","timestamp":1614088469000},"page":"3851-3862","source":"Crossref","is-referenced-by-count":12,"title":["Monitoring of gene expression in tacrolimus\u2010treated de novo renal allograft recipients facilitates individualized immunosuppression: Results of the IMAGEN study"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5080-0979","authenticated-orcid":false,"given":"Claudia","family":"Sommerer","sequence":"first","affiliation":[{"name":"Department of Nephrology, University of Heidelberg University Hospital Heidelberg  Heidelberg 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Transplant Unit, Nephrology Department Fundaci\u00f3 Puigvert  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Glander","sequence":"additional","affiliation":[{"name":"Department of Nephrology Charit\u00e9 University Hospital Berlin  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Meuer","sequence":"additional","affiliation":[{"name":"Institute of Immunology University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Zeier","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University of Heidelberg University Hospital Heidelberg  Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Giese","sequence":"additional","affiliation":[{"name":"Institute of Immunology University Hospital Heidelberg  Heidelberg 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