免疫检查点抑制剂介导肝毒性风险因素和生物标志物:新兴见解和未来前景
Zaoqin Yu1, Yanjiao Xu1, Wei Li1
1Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Journal of clinical and translational hepatology
|March 11, 2026
概括
免疫检查点抑制剂 (ICI) 改善癌症治疗,但可能导致肝损伤. 确定免疫媒介性肝毒性 (IMH) 的风险因素和生物标志物对于患者的安全至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
- 增加ICI的使用导致了免疫相关不良事件的增加,包括免疫媒介性肝毒性 (IMH).
- IMH带来了重大风险,需要早期发现和管理策略.
研究的目的:
- 审查接受ICI治疗的患者IMH风险因素的当前知识.
- 探索IMH潜在的预测生物标志物.
- 突出了早期IMH识别和管理方面的进一步研究的需要.
主要方法:
- 对IMH的风险因素和预测生物标志物的文献综述.
- 风险因素被分为与患者相关,与瘤相关和与代理相关的风险因素.
- 潜在生物标志物的总结,包括血细胞,血清蛋白,自身抗体,细胞因子,基因配置文件和肠道微生物群.
主要成果:
- 患者因素 (性别,年龄,BMI,种族,肝病),瘤因素 (癌症类型,先前的ICI) 和代理因素 (双重ICI,并发疗法) 与更高的IMH风险有关.
- 各种生物标志物显示出希望,但缺乏一致的预测价值.
- 目前还没有确定的生物标志物用于常规临床使用.
结论:
- 对于接受ICI治疗的患者来说,IMH的早期发现和个性化管理至关重要.
- 需要进一步的大规模前性研究来验证预测生物标志物.
- 将验证的生物标志物纳入临床实践将提高IMH预测和患者护理.
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