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Updated: Jul 6, 2026

Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
Published on: December 11, 2016
Graft rejection: pharmacogenetic analysis or drug anamnesis?
V Vi Pham1, Dirk O Stichtenoth, Jürgen Borlak
1Institute of Clinical Pharmacology, Medizinische Hochschule Hannover and Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany.
Aims:
A 23-year-old Caucasian woman, with cystic fibrosis, bilateral lung-transplantation and immunosuppressive therapy with prednisolone, tacrolimus and sirolimus, presented with clinical symptoms of a chronic transplant rejection.
Methods:
Since constant sufficient blood level of tacrolimus and sirolimus had never been achieved, a genetic analysis was carried out to clarify drug metabolism.
Results:
The genetic analysis for polymorphisms of cytochrome P450 (CYP) 3A4,5,7 revealed no sequence alterations in the CYP 3A4,5,7 gene. Thus, drug intake was scrutinized in detail, disclosing a missing interval between the intake of both immunosuppressive agents. After a correct drug intake the woman's condition ameliorated and the blood levels reached normal range.
Conclusions:
This case report highlights the crucial importance of basic medical skills like an accurate and dainty drug anamnesis before high tech approaches were applied.
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