免疫介导的腹和结肠炎与正常的生化,内镜和组织学发现:一个回顾性研究
Malek Shatila1, Sharada Wali1, Carolina Colli Cruz1
1The University of Texas MD Anderson Cancer Center, Department of Gastroenterology, Hepatology, and Nutrition, Houston, TX (Malek Shatila, Sharada Wali*, Carolina Colli Cruz*, Krishnavathana Varatharajalu, Anusha Shirwaiker Thomas, Yinghong Wang).
Annals of gastroenterology
|January 30, 2026
概括
没有炎症标志物的免疫媒介腹和结肠炎 (IMDC) 与PD-1/PD-L1抑制剂有关. 这些患者经历了较轻的症状和较少的住院治疗,尽管有些人仍然需要免疫抑制.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫媒介性腹和结肠炎 (IMDC) 可以发生在检查点抑制剂.
- 一部分患者呈现IMDC,但缺乏便生物标志物,内镜或组织学炎症证据.
- 对这个特定的IMDC群体的治疗和结果的理解是有限的.
研究的目的:
- 描述IMDC患者没有炎症证据的特征.
- 为了澄清免疫抑制治疗在管理IMDC子组中的作用.
- 调查PD-1/PD-L1抑制剂和这种特定的IMDC呈现之间的潜在联系.
主要方法:
- 单中心,回顾性研究.
- 纳入标准:接受免疫检查点抑制剂治疗的患者,在没有炎症证据的情况下出现IMDC临床症状 (便calprotectin,内镜,组织学).
- 研究期:2010年1月至2024年2月.
主要成果:
- 11.4%的IMDC患者 (131/1151) 没有出现炎症.
- 这些患者的PD-1/L1剂暴露率较高,腹不那么严重,住院率较低.
- 大约40%的人需要免疫抑制治疗,在接受和不接受免疫抑制治疗的人之间,症状或严重程度没有显著差异.
结论:
- 这是第一个使用正常炎症标志物的IMDC研究.
- 抑制PD-1/PD-L1可能会导致这种IMDC形式的发生,与较温和的结果相关.
- 尽管表现较温和,但免疫抑制治疗往往是必要的,一些患者可能会在以后发展出结肠炎症.
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