检查点抑制剂的免疫媒介性肝损伤:一个不断发展的边界与新出现的挑战
Lily Dara1, Eleonora De Martin2
1Research Center for Liver Disease, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
概括
检查点抑制剂 (ILICI) 引起的免疫媒介性肝损伤是癌症免疫疗法的严重副作用. 本综述涵盖了ILICI风险因素,呈现,治疗以及免疫治疗患者重新挑战的可能性.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
- 免疫相关的不良事件 (irAEs),包括检查点抑制剂 (ILICI) 引起的免疫媒介肝损伤,是显著的风险.
- ILICI可能需要停止治疗和免疫抑制.
研究的目的:
- 审查目前关于ILICI风险因素,表现和治疗的知识.
- 讨论对类固醇耐药的ILICI和免疫治疗的可能性再挑战.
- 识别ILICI的知识缺口和未来研究领域.
主要方法:
- 检查点抑制剂 (ILICI) 免疫媒介性肝损伤的文献综述.
- 对临床表现,风险因素和治疗策略的分析.
- 讨论新出现的概念,如免疫疗法重新挑战.
主要成果:
- ILICI的呈现是异质的,在发病,损伤模式 (肝炎与胆管炎) 和严重程度上有所不同.
- 细胞毒性T淋巴细胞 (CTLs) 是关键的,但免疫疗法影响整个免疫微环境.
- 类固醇耐药ILICI和再挑战策略存在临床挑战.
结论:
- 了解ILICI对于管理癌症免疫治疗副作用至关重要.
- 需要进一步的研究来解决异质性,耐火病例和安全的再挑战协议.
- 优化ILICI的管理可以改善免疫治疗患者的结果.
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