免疫检查点抑制剂相关心肌炎机制诊断和治疗的概述
Shuhui Feng1,2, Bingru Zhao1,2, Shuo Sha1,2
1Department of Cardiology, First Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China.
Frontiers in immunology
|December 15, 2025
概括
免疫检查点抑制剂相关心肌炎 (ICI-M) 是癌症治疗的罕见但严重的副作用. 了解其免疫原因和改善诊断成像是减少死亡率的关键.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 针对PD-1/PD-L1或CTLA-4的免疫检查点抑制剂 (ICI) 可以导致与免疫相关的不良事件.
- 免疫检查点抑制剂相关心肌炎 (ICI-M) 是一种罕见的,严重的,可能致命的并发症.
- 病原发生涉及免疫耐受性的丧失,自反应性T细胞和共享的瘤心脏抗原.
研究的目的:
- 审查关于ICI-M免疫病原发生的当前知识.
- 要总结ICI-M的诊断策略.
- 讨论ICI-M的新兴治疗干预措施.
主要方法:
- 关于ICI-M的最近研究的文献综述.
- 免疫病原性机制的分析,包括T细胞反应和抗原交叉反应.
- 评估诊断工具,如热波宁,心电图和先进的心脏成像 (CMR).
主要成果:
- ICI-M的发病过程复杂,涉及T细胞激活,抗原仿真和炎症级联.
- 临床表现是异质的,从轻微的症状到心脏性休克.
- 心血管磁共振 (CMR) 使用更新的路易斯湖标准和菌株分析提高了诊断灵敏度.
结论:
- 早期识别和准确诊断ICI-M对于患者的治疗结果至关重要.
- 先进的成像技术对于敏感的ICI-M检测至关重要.
- 免疫抑制疗法和针对性治疗的进一步研究是必要的,以有效地管理ICI-M.
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