尿路CXCL-9在免疫检查点抑制剂相关的急性间歇性炎的非侵入性诊断中优于TNF-α
Coraima Claudia Nava Chavez1, Sheila Bermejo2, Victor Cuenca Narvaez1
1Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
概括
尿液CXC动机化学联体9 (CXCL-9) 是一个比瘤亡因子α (TNF-α) 更有效的非侵入性生物标志物,用于诊断与免疫检查点抑制剂相关的急性间歇性炎 (ICI-AIN). 这一发现有助于区分ICI-AIN与在接受免疫治疗的患者中引起的其他急性损伤.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 活检是诊断免疫检查点抑制剂相关急性间歇性炎 (ICI-AIN) 的标准.
- 尿路生物标志物,如瘤亡因子α (TNF-α) 和CXC动机化学因子联体9 (CXCL-9) 显示出非侵入性ICI-AIN诊断的前景.
- 这些生物标志物在免疫治疗患者中缺乏直接比较.
研究的目的:
- 系统地比较尿液CXCL-9和TNF-α作为诊断ICI-AIN的非侵入性生物标志物.
- 评估这些生物标志物的诊断准确性,以区分ICI-AIN与在接受免疫治疗的患者中引起急性损伤 (AKI) 的其他原因.
主要方法:
- 预期招募ICI治疗的癌症患者,有或没有AKI (内部验证队列).
- 使用ELISA测量尿中的CXCL-9和TNF-α.
- 在西班牙的一组活检证明的ICI-AIN患者的外部验证.
主要成果:
- 与ICI-Non-AIN AKI和无AKI组相比,ICI-AIN患者的尿中CXCL-9水平显著更高 (p≤0.0001).
- 这些发现在外部验证队列中得到证实.
- 尿液CXCL-9在区分ICI-AIN和ICI-Non-AINAKI时,显示曲线下的面积 (AUC=0.83) 比TNF-α (AUC=0.63) 更高.
结论:
- 尿路CXCL-9是TNF-α的优越生物标志物,用于ICI-AIN的非侵入性诊断.
- 即使在暴露于皮质类固醇后,CXCL-9也显示出诊断的前景.
- 这种生物标志物可以帮助免疫治疗相关损伤患者的临床决策.
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