免疫检查点抑制剂诱导的炎症性关节炎:疗法概述和个性化方法,以优化组合疗法
Noa Rose1, Victoria Furer1, Ari Polachek1
1Department of Rheumatology, Tel Aviv Sourasky Medical Center affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
European journal of rheumatology
|March 13, 2024
概括
免疫检查点抑制剂 (ICI) 可以导致免疫相关的不良事件,如关节炎. 本综述涵盖了ICI亚型,类风湿性IRA和管理策略,提出了个性化诊断以更好地选择治疗.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 类风湿病学 类风湿病学
背景情况:
- 免疫检查点抑制剂 (ICI),如抗CTLA-4和抗PD-1/PD-L1抗体,在癌症治疗中至关重要,增强抗瘤免疫力.
- 然而,ICI可以引发与免疫相关的不良事件 (irAEs),原因是免疫反应加剧影响健康组织.
- 类风湿性IRAE,特别是关节炎,很常见,需要根据严重程度进行仔细管理.
研究的目的:
- 审查当前的免疫检查点抑制剂 (ICI) 亚型及其与类风湿性免疫相关不良事件 (irAEs) 的关联.
- 总结现有的治疗策略来管理ICI诱导的类风湿性IRE.
- 为个人选择ICI和抗风湿药物组合提出一种ex vivo诊断试验.
主要方法:
- 关于免疫检查点抑制剂 (ICI) 和它们在免疫相关不良事件 (irAEs) 中的作用的文献综述.
- 分析目前的临床实践,以管理ICI诱导的类风湿性IRAE,包括药理干预措施.
- 探索一种新的ex vivo个性化诊断试验,以优化治疗策略.
主要成果:
- 虽然ICI在癌症治疗中有效,但与包括关节炎在内的各种irAEs有关.
- 风湿性IRAE的治疗包括葡萄糖皮质类药物,疾病修饰性抗风湿药物 (DMARD) 和生物药物.
- 审查强调需要个性化方法来缓解ICI诱导的不良事件.
结论:
- 了解ICI亚型及其irAE概况对于患者安全至关重要.
- 目前对类风湿性IRAE的治疗依赖于已知的免疫抑制和抗炎疗法.
- 个性化诊断试验对量身定制ICI治疗和预防不良事件具有前景.
相关概念视频
Tumor Immunotherapy
524
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
524
Inflammatory Bowel Disease IV: Pharmacological Management
127
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
127
Inflammatory Response
2.0K
An inflammatory response is a localized, nonspecific immune reaction that occurs when a tissue is injured. It is characterized by redness, swelling, heat, and pain, which are commonly called the cardinal signs and symptoms of inflammation. Inflammation can sometimes result in a loss of function.
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
2.0K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
163
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
163
Autoimmune Disorders
431
Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
Concept and Mechanism of Autoimmune Diseases
The immune...
Concept and Mechanism of Autoimmune Diseases
The immune...
431
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
137
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
137


