免疫检查点抑制剂相关性心肌炎发病机制研究进展

Research progress on the pathogenesis of immune checkpoint inhibitor-associated myocarditis

免疫检查点抑制剂已成为应用最广的肿瘤免疫疗法,伊匹木单抗和纳武利尤单抗是其中的代表药物。但免疫检查点抑制剂的使用也带来许多免疫相关不良事件,其中心肌炎是最致命的不良反应之一。免疫检查点抑制剂相关性心肌炎的发病机制尚不完全清楚,主要包括自身免疫性T淋巴细胞浸润、调节性T细胞功能障碍、细胞因子、自身抗体的产生、遗传学因素、肠道微生物组等方面,免疫检查点抑制剂相关性心肌炎的治疗及管理需要多学科专家的共同努力。

Immune checkpoint inhibitors(ICIs)have become the most widely used drugs in tumor immunotherapy,with ipilimumab and nivolumab as their representatives.However,the use of immune checkpoint inhibitors has brought about many immune-related adverse events,of which myocarditis is one of the most fatal adverse reactions.The pathogenesis of immune checkpoint inhibitor-associated myocarditis is not fully understood,mainly involving autoimmune T lymphocyte infiltration,regulatory T-cell dysfunction,cytokines,autoantibody production,genetic factors,the gut microbiome,etc.The treatment and management of immune checkpoint inhibitor-associated myocarditis require concerted efforts of multidisciplinary experts.