Transplantation & Drug Metabolism
Health Sciences Clinical Professor of Pharmacy
Skaggs School of Pharmacy and Pharmaceutical Sciences
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 in healthy volunteers; 2) analyzing skin swab metabolomics for drug exposure; 3) understanding pharmacogenomic factors contributing to tacrolimus nephrotoxicity; 4) investigating the clinical utility of pharmacogenomics in transplant patients; and 5) studies with immunosuppressive drugs in transplant patients.
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:
Chair, Associated Health Professions Education Committee (AHPEC), UCSD School of Medicine; Vice Chair, American Liver Foundation Associate Medical Advisory Committee; Chair, Faculty Search Committee, UCSD SSPPS.
- Pharmacy: Therapeutics (SPPS 212A)
- Principles of Pharmacology and Physiology
- Hepatitis and Solid Organ Transplant Electives
- Dr. Tsunoda maintains a clinical practice in the liver transplant clinic at UC San Diego
- 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
- 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. (2016) Evaluation of proposed in vivo probe substrates and inhibitors for phenotyping transporter activity in humans. J Clin Pharmacol 56 (Suppl 7):S82-98.
- Patel S, Mendler M, Valasek M, Tsunoda SM (2018) Drug-induced liver injury associated with use of everolimus in a liver transplant patient. Case Rep Transpl doi: 10.1155/2018/7410508
- Yang Y, Patel M, Nikanjam M, et al. (2018) Midazolam single time point concentrations to estimate exposure and cytochrome P450 (CYP) 3A constitutive activity utilizing limited sampling strategy with a population pharmacokinetic approache. J Clin Pharmacol 58(9):1205-1213.
- Jarmusch AK, Elijah EO, Vargas F, Bouslimani A, da Silva RR, Ernst M, Wang M, del Rosario KK, Dorrestein PC, Tsunoda SM. (2019) Initial development toward non-invasive drug monitoring via untargeted mass spectrometric analysis of human skin. Anal Chem, DOI:10.1021/acs.analchem.8b05854.
Selected Recent Publications (view more)
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Phase I investigations of new compounds that are CYP3A and/or p-glycoprotein substrates, particularly those used in transplantation.
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Phase I-III investigations of mTOR inhibitor compounds
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Pharmacokinetic and drug metabolism studies in liver disease and liver transplantation