免疫检查点抑制剂介导的肝毒性的研究进展

Research progress of immune checkpoint inhibitor mediated hepatotoxicity

10余年来,免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)的应用在肿瘤治疗中取得了瞩目成就。然而,随着ICIs使用的增多和适应证的扩大,免疫相关不良事件(immune-related adverse events,irAEs)也随之增加。在这些不良反应中,免疫治疗介导的肝毒性(immunotherapy mediated hepatotoxicity,IMH)的发病率为1%~15%。本文结合近期的研究报道,对IMH的发生机制、诊断、治疗及预后等作一综述,为临床工作中IMH的诊治提供相关信息。

In the last decade,remarkable achievements have been made in anti-tumor treatment of immune checkpoint inhibitors(ICIs).However,immune-related adverse events(irAEs)increased with the increasing use and expansive indications of ICIs.Among irAEs,the incidence of immunotherapy meditated hepatotoxicity(IMH)ranged from 1%-15%.Based on recent studies,we made a review of the pathogenesis,diagnosis,treatment and prognosis of IMH to guide the diagnosis and treatment of IMH in clinical work.