[与免疫检查点抑制剂相关的神经副作用]
Wouter W van Willigen1,2, Dieuwke A Schreurs3, Frank M Speetjens4
1Leids Universitair Medisch Centrum, afd. Interne Geneeskunde, Leiden.
Nederlands tijdschrift voor geneeskunde
|January 22, 2025
概括
检查点抑制剂提供癌症益处,但可能导致与免疫相关的不良事件 (irAEs). 神经性irrAEs呈现出各种症状,具有挑战性的诊断,需要及时识别以防止严重后果.
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:
- 检查点抑制剂 (CPI) 在癌症治疗中至关重要,改善了结果.
- CPI与免疫相关的不良事件 (irAEs) 有关.
- 神经性IRAE (神经IRAE) 是IRAE的一个子集,具有不同的表现.
研究的目的:
- 为了突出神经IRAE的诊断挑战.
- 为了说明神经IRAE的各种临床表现.
- 强调在接受CPI的患者中识别神经IRAEs的重要性.
主要方法:
- 案例系列呈现.
- 对临床症状和诊断考虑的审查.
- 讨论神经IRAEs的差异诊断.
主要成果:
- 介绍了三种不同的神经激发症的不同病例.
- 表现出各种症状,包括肌肉衰弱,感官障碍,和双眼视.
- 由于疾病进展或其他神经疾病的症状模仿,突出诊断困难.
结论:
- 由于其多样化且往往非特异性的症状,神经IRAE需要高度的临床怀疑.
- 及时诊断和管理神经性IRAE对于避免严重的神经并发症至关重要.
- 医疗保健提供者必须在CPI利用率增加的背景下意识到神经IRAE.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
147
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
147
Local Anesthetics: Adverse Effects
386
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
386
Psychoneuroimmunology: Diabetes and Cancer
22
Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
22
Cytotoxic T Cells-mediated Immune Response
836
Cytotoxic T cells are a vital component of the immune system. They have the remarkable ability to identify and target antigens on infected or abnormal cells. These antigens often originate from intracellular pathogens such as viruses or abnormal proteins cancer cells produce.
Immunological surveillance is the ability of immune cells to monitor and eliminate infected cells with intracellular pathogens, neoplastically transformed cells, and cells with non-self antigens. Cytotoxic T cells and NK...
Immunological surveillance is the ability of immune cells to monitor and eliminate infected cells with intracellular pathogens, neoplastically transformed cells, and cells with non-self antigens. Cytotoxic T cells and NK...
836
Tumor Immunotherapy
467
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.
467


