免疫检查点抑制剂和心血管毒性:免疫学,病理生理学,诊断和管理
1Cardiovascular-Oncology Program, University of Cincinnati Cancer Center, Cincinnati, OH, 45267, USA. Richard.becker@uc.edu.
Journal of thrombosis and thrombolysis
|July 17, 2025
概括
免疫检查点抑制剂 (ICI) 增强癌症治疗,但可能导致严重的心脏问题,如心肌炎. 早期检测和管理,包括皮质类固醇,对于治疗ICI诱导的心脏毒性至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
背景情况:
- 免疫检查点抑制剂 (ICI) 在治疗晚期癌症,特别是肺癌方面至关重要.
- ICI针对PD-1,PD-L1和CTLA-4等途径来增强抗瘤免疫力.
- 然而,ICI可以诱导与免疫相关的不良事件,特别是心脏毒性和血管炎.
研究的目的:
- 审查与免疫检查点抑制剂相关的心血管毒性.
- 概述ICI诱导心脏毒性的诊断和管理策略.
- 强调监测和及时干预的重要性.
主要方法:
- 对ICI相关心血管不良事件研究的文献综述.
- 分析临床表现,诊断工具和治疗方案.
- 专注于心肌炎,心膜炎,心律失常和血管炎.
主要成果:
- 心脏毒性,特别是心肌炎,是ICI的显著且可能致命的不良事件.
- 组合免疫疗法可能会增加心肌炎的风险.
- 有效的管理需要对心脏生物标志物和功能进行警监测.
结论:
- 早期识别和干预对于管理ICI诱导的心脏毒性至关重要.
- 治疗包括ICI中止,皮质类固醇和支持性护理.
- 耐药病例可能需要进一步的免疫抑制治疗.
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