Dr. Shirley M. Tsunoda

Drug Metabolism, Microbiome, Transplantation

Tsunoda's picture
Shirley M. Tsunoda, Pharm.D.

Professor of Clinical Pharmacy
Skaggs School of Pharmacy and Pharmaceutical Sciences

(858) 822-6629
Research Summary

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 the role of the microbiome on intestinal and hepatic drug metabolism.

Dr. Tsunoda has several ongoing research projects in: 1) investigating the effect of the microbiome on drug metabolism; 2) analyzing skin swab metabolomics for drug exposure; 3) investigating the clinical utility of pharmacogenomics in transplant patients; and 4) studies with immunosuppressive drugs in transplant patients.


Academic Achievements


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) ; UC San Diego Faculty Leadership Academy (2020); UC San Diego SSPPS Faculty Member of the Year, P3 class (2020).

Leadership Experience:

Chair, Associated Health Professions Education Committee (AHPEC), UCSD School of Medicine; Vice Chair, American Liver Foundation Associate Medical Advisory Committee;  Co-Director SSPPS Mentoring Training Program.

  • Pharmacy: Therapeutics (SPPS 212A)
  • Principles of Pharmacology and Physiology
  • Pharmacogenomics
  • Hepatitis and Solid Organ Transplant Electives
Clinical Practice
  • Dr. Tsunoda maintains a clinical practice in the liver transplant clinic at UC San Diego
Key Contributions
  • Investigation of the impact of the gut microbiome on drug metabolism
  • Differentiation of intestinal and hepatic CYP3A4 activity using midazolam as an in vivo probe
  • Characterization of drugs in non-invasive skin swab samples
  • Clinical research in liver transplant patients
Selected Publications


  • Tsunoda SM, et. al (2001)  Red wine decreases cyclosporine bioavailability.  Clin Pharmacol Ther 70:462-7.
  • Momper JD, Tsunoda SM, Ma JD. (2016) Evaluation of proposed in vivo probe substrates and inhibitors for phenotyping transporter activity in humans.  J Clin Pharmacol  56 (Suppl 7):S82-98.
  • Yang J, et. al (2019) Midazolam limited sampling strategy with a population pharmacokinetic approach to simultaneously estimate cytochrome P450 (CYP) 3A constitutive, inhibition, and induction/activation conditions in healthy adults.  J  Clin Pharmacol 59(11):1495-1504.
  • Jarmusch AK, et. al (2019) Initial development toward non-invasive drug monitoring via untargeted mass spectrometric analysis of human skin.  Anal Chem, DOI:10.1021/acs.analchem.8b05854.
  • Deininger KM, et. al (2019) Stakeholder perspectives of the clinical utility of pharmacogenomic testing in solid organ transplantation.  Pharmacogenomics. 20(18):1291-1302.
  • Jarmusch AK, et. al (2020) Enhanced characterization of drug metabolism and the influence of the intestinal microbiome:  a pharmacokinetic, microbiome, and untargeted metabolomics study.  Clin Transl Sci.
  • Deininger KM, et. al (2020) National survey of physicians’ perspectives on pharmacogenetic testing in solid organ transplantation.  Clin Transplant.

Selected Recent Publications (view more)

Potential Collaborative Programs
  • Clinical investigations of the gut microbiome's effect on drug metabolism

  • 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 ​