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Pathology of immune-mediated tissue lesions following treatment with immune checkpoint inhibitors
Hajir Ibraheim1,2, Esperanza Perucha3, Nick Powell1,2
1Division of Digestive Diseases, Faculty of Medicine, Imperial College London, UK.
Abstract:
Immune check point inhibitor (CPI) therapy has revolutionized treatment paradigms for several cancers, but at the cost of triggering a diverse spectrum of immune-mediated injury to non-cancer tissues. The complex biology of these toxicities remains incompletely understood, partly because tissue acquisition from affected areas can be challenging to retrieve, thus hindering development of targeted therapy. Here, we review the literature describing pathology of immune-mediated tissue lesions including gastrointestinal, skin, rheumatic, pulmonary, cardiac, renal and hepatic lesions and highlight key immunological insights.
Insights
Immune checkpoint inhibitor (CPI) therapy causes immune-mediated tissue damage. This review details the pathology of these toxicities across various organs, aiding understanding and targeted therapy development.
Area of Science:
- Oncology
- Immunology
- Pathology
Background:
- Immune checkpoint inhibitor (CPI) therapy has transformed cancer treatment.
- CPIs can cause immune-mediated adverse events (irAEs) affecting various non-cancerous tissues.
- The underlying biology and pathology of irAEs are not fully understood.
Purpose of the Study:
- To review the literature on the pathology of immune-mediated tissue lesions caused by CPIs.
- To highlight key immunological insights into these toxicities.
- To inform the development of targeted therapies for irAEs.
Main Methods:
- Comprehensive literature review of studies describing CPI-induced immune-mediated tissue lesions.
- Analysis of pathological findings across affected organ systems.
- Synthesis of immunological mechanisms contributing to irAEs.
Main Results:
- CPIs induce a wide range of immune-mediated injuries affecting gastrointestinal, skin, rheumatic, pulmonary, cardiac, renal, and hepatic tissues.
- Pathological features vary depending on the affected organ system.
- Key immunological insights into the mechanisms of irAEs are presented.
Conclusions:
- Understanding the pathology of irAEs is crucial for managing CPI therapy.
- Further research into the immunological basis of these toxicities is needed.
- This review provides a foundation for developing targeted therapeutic strategies to mitigate irAEs.
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