免疫检查点抑制剂相关性肝毒性研究进展

Immune checkpoint inhibitor-induced immune-mediated hepatitis:Review and outlook

免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)作为肿瘤治疗领域近年来取得的重大进展之一,通过阻断免疫抑制进而重新激活T细胞,恢复其对肿瘤细胞的杀伤发挥抗肿瘤作用,极从而大程度地改善肿瘤患者的生存获益。但ICIs在发挥作用的同时也会非特异性激活免疫系统,导致免疫耐受失衡,损伤正常器官组织,这类不良事件即为免疫相关不良反应(immune-related adverse events, irAEs)。随着ICIs的广泛应用,其引发的irAEs的数量及类型不断增多已成为不容忽视的临床问题。其中,免疫检查点抑制剂相关性肝毒性(ICI-induced immune mediated hepatitis, IMH)作为一种潜在的致命性不良反应,对于其时间及结果尚无透彻的研究。

As one of the major advances in tumor therapy in recent years,immune checkpoint inhibitors(ICIs)can greatly improve the survival of tumor patients by blocking immunosuppression and reactivating T cells to resume their anti-tumor effects on tumor cells.In addition to the protective role,ICIs can also activate the immune system non-specifically,leading to an imbalance of immune tolerance and damages to normal organs and tissues,which are known as immune-related adverse events(irAEs).With the wide application of ICIs,the increasing number and types of ICI-induced irAEs have become a clinical problem that cannot be ignored.Among them,ICI-induced immune-mediated hepatitis(IMH)is a potentially fatal adverse event that has not been thoroughly studied for its timing and outcome.