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Dr. Shirley M. Tsunoda

Transplantation

Shirley M. Tsunoda

Shirley M. Tsunoda, Pharm.D.

Health Sciences Clinical Professor of Pharmacy
Skaggs School of Pharmacy and Pharmaceutical Sciences

Email
smtsunoda@ucsd.edu

Phone
(858) 822-6629


Research Summary: Transplantation & Drug Metabolism

Dr. Tsunoda’s research focuses on factors influencing the variability and activity of intestinal and hepatic metabolism of drugs and the pharmacokinetics/metabolism and clinical use of immunosuppressive agents. Previous work has included using probe compounds such as midazolam and cyclosporine to predict activity of CYP3A4, the major drug metabolizing enzyme in the intestine and liver and the effect of red wine on cyclosporine pharmacokinetics. She is also interested in studying the increasingly complex interplay of the metabolic enzymes and transporter proteins in the intestine and how they contribute to the overall bioavailability of immunosuppressive drugs; as well as investigating methods to probe intestinal and hepatic transporters.

Dr. Tsunoda has several ongoing research projects in transplant patients. These include: 1) investigating the effect of everolimus on hepatic and renal biomarkers in liver transplant patients; 2) understanding factors contributing to successful treatment of post-transplant hepatitis C; 3) understanding pharmacogenomic factors contributing to tacrolimus nephrotoxicity; and 4) investigating the clinical utility of an immune cell function assay as a biomarker in liver transplantation.

Academic Achievements

Education:

B.S. in Psychobiology (1987), UCLA; Pharm.D. (1992) UCSF; Residency in Pharmacy Practice (1993) UCSF; Post-doctoral Fellowship in Pharmacokinetics/Drug Metabolism (1995) UCSF. 

Awards and Honors:

UCSF Resident Research Project Award (1993); American Association of Colleges of Pharmacy New Investigator Award (1996); National Center for Leadership in Academic Medicine, UCSD (2007); American Society for Clinical Pharmacology and Therapeutics Member of the Month (2011); American Society for Clinical Pharmacology and Therapeutics Dedicated Member (2012); American Association of Colleges of Pharmacy Teacher of the Year (2016) 

Leadership Experience:

Co-Chair, Committee on Educational Policy, SSPPS, Delegate, American Association of Colleges of Pharmacy (2016-2018); Vice-Chair, Organ Specific Diseases Section (2010-2012) Chair, Organ Specific Diseases Section (2012-2014), American Society of Clinical Pharmacology and Therapeutics.   

Teaching

  • Pharmacy: Therapeutics (SPPS 212A).
  • Principles of Pharmacology and Physiology.
  • Hepatitis and Solid Organ Transplant Electives

Clinical Practice

  • Dr. Tsunoda maintains a clinical practice in the liver transplant clinic at UCSD.

Key Contributions to Pharmaceutical Sciences

  • Differentiation of intestinal and hepatic CYP3A4 activity using midazolam as an in vivo probe.
  • Investigation of factors contributing to the variability of CYP3A4 enzyme activity
  • Clinical research in liver transplant patients

Selected Recent Publications (view more)

  • Tsunoda et al. (1999). Differentiation of intestinal and hepatic cytochrome P450 3A activity with use of midazolam as an in vivo probe: effect of ketoconazole. Clin Pharmacol Ther 66:461-471. 
  • Tsunoda et al. (2001). Red wine decreases cyclosporine bioavailability. Clin Pharmacol Ther 70:462-467. 
  • Tsunoda et al. (2008). Telbivudine for the treatment of hepatitis B disease. Future Virology 3:517-527. 
  • Ma JD et al. (2010). Evaluation of in vivo p- glycoprotein phenotyping probes: a need for validation. Clin Pharmacokinet, 49:223-37. 
  • Masters JC, et al. (2015). Limited sampling strategy of partial area under the concentration-time curves to estimate midazolam systemic clearance for cytochrome P50 3A phenotyping. Ther Drug Monit, 37:84-89.
  • Momper JD, Tsunoda SM, Ma JD. Evaluation of proposed in vivo probe substrates and inhibitors for phenotyping transporter activity in humans. J Clin Pharmacol 56(Suppl 7):S82-98.

Potential Collaborative Programs with the Pharmaceutical Industry

  • Phase I investigations of new compounds that are CYP3A and/or p-glycoprotein substrates, particularly those used in transplantation. 

  • Phase I-III investigations of mTOR inhibitor compounds ​

  • Pharmacokinetic and drug metabolism studies in liver disease and liver transplantation