由于检查点抑制导致的外周神经系统免疫相关不良事件
Meabh O'Hare1,2, Amanda C Guidon3,4
1Brigham and Women's Hospital, Division of Neuromuscular Medicine, Department of Neurology, Boston, MA, USA. mohare@bwh.harvard.edu.
Nature reviews. Neurology
|August 9, 2024
概括
免疫检查点抑制剂可以引起影响周围神经系统 (PNS) 的免疫相关不良事件 (irAEs). 本综述详细介绍了PNS irAEs,它们的机制以及癌症患者的管理策略.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 神经学 神经学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗.
- 由ICI引起的T细胞活性增加可能导致影响各种器官的免疫相关不良事件 (irAEs).
- 神经性irrAEs很常见,三分之二的病例涉及周围神经系统 (PNS).
研究的目的:
- 审查与免疫检查点抑制剂相关的周围神经系统 (PNS) 不良事件.
- 讨论这些神经性IRAE的潜在病理生理机制.
- 提供当前和新兴的临床管理策略的概述.
主要方法:
- 文献综述侧重于ICI产生的PNS不良事件.
- 讨论病理生理机制,包括抗原同质性,表位扩散和自身反应性T细胞.
- 临床管理方法的概述,包括细胞因子导向疗法.
主要成果:
- 与免疫相关的肌肉病是最常见的PNS irAE,有时涉及神经肌肉结.
- 与免疫相关的外围神经病变通常以多基核神经病变或神经病变的形式出现.
- 覆盖综合征,如肌肉病与心肌炎,与增加的死亡率有关.
结论:
- 对于免疫检查点抑制剂治疗来说,PNS不良事件是一个重大问题.
- 了解抗原同质性和表位分布等机制至关重要.
- 有效的管理策略正在发展,以平衡抗癌免疫和自身免疫.
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