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由ICI诱导的粒状腺炎对普雷尼松有反应性

Rachel J Kulchar, Amara Ogbonnaya-Whittlesey, Margaret E Beach

medRxiv : the preprint server for health sciences

|February 6, 2026

概括

免疫检查点抑制剂可能会导致罕见的副作用,如颗粒状腺炎,影响唾液腺. 早期识别和治疗对于在癌症治疗期间保持腺体功能至关重要.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
病理学病理学病理学

背景情况:

免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
与免疫相关的不良事件 (irAEs) 是ICI的常见副作用.
颗粒状腺炎是一种罕见的影响唾液腺的irAE.

研究的目的:

报告ICI诱导的颗粒状腺炎的第一个病例.
为了调查这种irAE的潜在机制.
评估治疗干预措施的有效性.

主要方法:

一位患有BRAF-V600E突变乳头甲状腺癌的患者的病例介绍,该患者接受了ICI治疗.
综合性分析包括组织学,单细胞RNA测序和空间转录学.
对皮质类固醇治疗反应的评估.

主要成果:

患者出现了急性异口症和唾液功能下降.
分析揭示了巨细胞和T细胞介导的上皮损伤与Th1极化炎症.
皮质类固醇治疗改善了唾液流和组织结构,但没有解决纤维化.

结论:

由ICI引起的颗粒状腺炎是一种独特的irAE.
早期识别和干预对于管理IRE至关重要.
及时治疗可以保持腺体功能,并允许继续癌症治疗.

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