通过免疫检查点抑制剂诱导的类固醇耐药免疫中介性肝毒性的临床病理特征
Tomonobu Hioki1, Koji Imoto1, Takeshi Goya1
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
BMC gastroenterology
|December 17, 2025
概括
甲酸莫菲提尔 (MMF) 有效治疗类固醇耐药免疫检查点抑制剂诱导的免疫中介肝毒性 (IMH),特别是当胆管炎存在时. 建议在患有胆道炎的组织学证据的患者早期进行MMF治疗.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂诱导的免疫中介肝毒性 (IMH) 是一种严重的不良事件.
- 菌酸莫菲提尔 (MMF) 是一种潜在的二线治疗类固醇耐药性IMH的治疗方法.
- 有限的数据存在于临床病理学特征和MMF在类固醇耐药IMH中的疗效.
研究的目的:
- 调查类固醇耐火性IMH的临床病理学特征.
- 评估MMF作为二线治疗类固醇耐药IMH的疗效和安全性.
- 确定MMF在IMH中的反应预测因素.
主要方法:
- 对33名病理诊断的IMH患者进行了回顾性研究.
- 对肝活检结果,治疗反应和不良事件的分析.
- 基于临床和组织学数据的货币市场基金响应者和不响应者的比较.
主要成果:
- 与耐固醇IMH (27.8%) 相比,耐固醇IMH表现出明显更频繁的胆管炎 (70.0%).
- 在10个耐固醇IMH病例中的9个中,MMF是安全有效的.
- 没有反应的MMF患者有更多的胆固醇/混合模式,并且从类固醇开始到MMF开始的间隔更长.
结论:
- 胆管炎是固醇耐火性IMH的一个突出特征.
- MMF是一种安全有效的二线治疗类固醇耐火性IMH.
- 建议IMH患者进行早期MMF诱导,IMH患者有组织性胆道炎.
更多相关视频
相关概念视频
Cell-mediated Immune Responses
83.3K
Overview
83.3K
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
459
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
459
Pulmonary Tuberculosis I
802
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
802


