程序性细胞死亡蛋白-1抑制剂的神经肌肉不良反应

Neuromuscular adverse events associated with programmed cell death-1 inhibitors

程序性细胞死亡蛋白-1(programmed cell death-1,PD-1)可优先在机体 B 细胞、T 细胞和自然杀伤细胞中表达,是一种重要的免疫检查点抑制剂。PD-1有两个配体,即程序性死亡配体(programmed death-ligand,PD-L)1和PD-L2。PD-1可防止T细胞过度活化和下调免疫应答,在降低自身免疫反应和促进自身耐受中发挥重要作用。PD-1信号被肿瘤用于逃避免疫杀死,近年来FDA批准多种PD-1抑制剂被用于诱导抗肿瘤免疫应答并取得一定临床疗效,但在治疗过程中也发生很多药物不良反应。该文对PD-1抑制剂在神经科应用过程中产生的神经肌肉并发症等进行综述,以期为PD-1抑制剂规范应用提供参考。

As an important immune checkpoint inhibitor,programmed cell death-1(PD-1) is preferentially expressed in B cells,T cells and natural killer cell.PD-1 has two ligands:programmed death-ligand(PD-1)1 and PD-L2.PD-1 can prevent T cell over activation and down-regulate immune response,and plays an important role in reducing autoimmune response and promoting self tolerance.PD-1 signaling is used by tumors to escape immune killing.In recent years,a variety of PD-1 signaling inhibitors have been approved by FDA to induce anti-tumor immune response,which have achieved certain clinical efficacy,but many adverse drug reactions also occur in the treatment process.In this article,we reviewed the neuromuscular complications of PD-1 inhibitors in neurology in order to provide reference for standardized application of PD-1 inhibitors.