• Prof. Van Gelder Teun

CV

Prof. Teun van Gelder is an internist trained in nephrology and clinical pharmacology.  From 1988 -2019 he worked at the Erasmus Medical Center in Rotterdam. In December 2019 Teun accepted a new position in Leiden University Medical Center as Professor in Drug Discovery & Development. In this role he is responsible for the research theme Academic Pharma. He combines clinical work (kidney transplantation and clinical pharmacology) with teaching and research (10 PhD students). He was the chair of the Dutch Society for Clinical Pharmacology & Biopharmacy and the president of the International Association for Therapeutic Drug Monitoring and Clinical Toxicology.

ABSTRACT

Pharmacogenetics in solid organ transplantation: ready for implementation?

The immunosuppressive drugs used in solid organ transplantation have narrow therapeutic ranges and highly variable pharmacokinetics between individuals. The most frequently prescribed drug is tacrolimus, of which the exposure strongly correlates with the expression and activity of the metabolizing enzymes cytochrome P450 (CYP) 3A4 and CYP3A5. These enzymes are polymorphically expressed, which is in part explained by the presence of single-nucleotide polymorphisms in the CYP3A4 and CYP3A5 genes.  There are striking differences in the prevalence of the different genotypes among patients with varying ethnicity. The higher dose requirement of patients expressing CYP3A5 may cause a delay in reaching the desired tacrolimus target concentrations, potentially with reduced efficacy as a result. The question is whether the implementation of pre-transplantation genotyping will benefit patient management.