摘要
免疫检查点抑制剂是一种新兴的肿瘤免疫治疗方法,通过靶向细胞毒性T淋巴细胞相关抗原(cytotoxic T lymphocyte-associated protein-4,CTLA-4)、程序性死亡受体-1(programmed death-1,PD-1)和程序性死亡配体-1(programmed death ligand-1,PD-L1)达到抗肿瘤的效果,极大延长了晚期肿瘤患者的生存时间。然而,免疫检查点抑制剂在激活免疫系统抗肿瘤的同时,也可能会对患者的多个器官系统造成损伤,内分泌副反应是最为常见的副反应之一。由于免疫检查点抑制剂越来越多地应用于临床,其引起的免疫相关内分泌副反应如果未被及时识别,可能会对患者造成生命危险。本文就目前研究中发现的免疫相关内分泌副反应的发病率及其可能的发病机制进行综述,同时,探讨免疫相关内分泌副反应的临床管理策略,为临床医生诊疗工作提供帮助。
As a new method of immunotherapy against tumor,immune checkpoint inhibitors greatly improve patients survival,by blocking cytotoxic T lymphocyte-associated protein 4(CTLA-4),programmed cell death 1(PD-1)protein or its ligand PD-L1.However,immune checkpoint inhibitors can also have side-effects in different organ systems while increasing the activity of the immune system against tumor.Endocrine side-effects are among the most common adverse events reported in clinical practice,including hypophysitis,thyroid dysfunction,insulin-deficient diabetes(IDD)and primary adrenal insufficiency(PAI).Given the increasing use of immune checkpoint inhibitors and the potential life-threatening of endocrine side-effects,it is meaningful to have a full understanding of the endocrine side-effects.This article reviews the incidence of the immune-related endocrine side-effects and their potential mechanisms,as well as the management strategies in clinical practice.
作者
樊鹏宇(综述)
张鹏(审校)
FAN Peng-yu;ZHANG Peng(Tongji University School of Medicine,Shanghai 200092,China;Dept.of Thoracic Surgery,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433,China)
出处
《同济大学学报（医学版）》
CAS
2020年第5期654-661,共8页
Journal of Tongji University(Medical Science)
基金
国家自然科学基金面上项目(81972172)。
关键词
免疫治疗
免疫检查点抑制剂
免疫相关副反应
内分泌副反应
immunotherapy
immune checkpoint inhibitors
immune related adverse events
endocrine side-effects
