免疫检查点抑制剂相关内分泌不良反应的研究进展

Research progress of immune checkpoint inhibitors and related endocrine side effects

免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)作为癌症治疗领域最重要的进展,为癌症患者带来新的希望。ICIs主要针对细胞程序性死亡受体-1(programmed cell death receptor-1,PD-1)、程序性死亡配体-1(programmed death-ligand 1,PDL1)以及细胞毒性T淋巴细胞相关蛋白-4(cytotoxic T-lymphocyte antigen-4,CTLA-4)。随着使用ICIs增加,越来越多的免疫相关不良反应(immune-related adverse effects,irAEs)被报道,其中内分泌腺体的累及尤为常见。这些irAEs的发病机制不完全明确,临床表现复杂,需要得到临床医生的充分重视。本文就ICIs作用机制及irAEs中的内分泌相关不良反应的研究进展作一综述,归纳总结其现有发病机制研究、流行病学及临床表现。

Immune checkpoint inhibitors(ICIs)are novel drugs used in recent years for cancer treatment,and they have brought new hope for several patients.Currently,the targets of ICIS are programmed cell death receptor-1(PD-1),programmed cell death-ligand 1(PD-L1),and cytotoxic T-lymphocyte antigen-4(CTLA-4).With the increasing use of ICIs,more immune-related adverse effects(irAEs)have been reported,and the involvement of endocrine glands is particularly common.The pathogenesis of these irAEs is unknown,and their clinical manifestations are complex;thus,clinicians need to pay more attention to such irAEs.In this review,the mechanism of ICIs and research progress of endocrine side effects are assessed,and pathogenesis,epidemiology,and clinical manifestations are also summarized.