免疫检查点抑制剂治疗带来的问题——免疫相关不良反应irAEs

Problems associated with immune checkpoint inhibitor therapy——immune related adverse reactions irAEs

免疫检查点抑制剂(ICIs)能够阻断免疫检查点通路、使机体重新产生抗肿瘤免疫的单抗。主要有抗细胞毒性T淋巴细胞相关抗原4(CTLA-4)抗体,抗程序性死亡受体1(PD-1)抗体和抗程序性死亡配体(PD-L1)抗体。ICIs治疗肿瘤的同时能破坏免疫耐受引起炎症反应,被称为免疫相关不良反应(irAEs)。近年也有报道称irAEs有望成为ICIs中一种独特的临床生物标志物。本文阐述irAEs的发生类型、主要涉及器官(皮肤、胃肠道、肺和内分泌系统)的表现形式、发生率以及其他irAEs影响因素。

Immune checkpoint inhibitors(ICIs)are the monoclonal antibodies that block the immune checkpoint pathway and release the body’s anti-tumor immunity. There are mainly cytotoxic T lymphocyte-associated antigen-4(CTLA-4)antibodies,anti-programmed death 1(PD-1)antibodies and anti-programmed death ligand 1(PD-L1)antibodies. ICIs treat tumors while destroying immune tolerance and causing inflammatory reactions,known as immune-related adverse events(irAEs). In recent years,it has been reported that irAEs is expected to become a unique clinical biomarker in ICIs. This paper mainly describes the occurrence types of irAEs,mainly involving the manifestation and incidence of organs(skin,gastrointestinal tract,lung and endocrine system),as well as other influencing factors of irAEs.