免疫检查点抑制剂相关性肝毒性的研究进展  

Clinical Progress of ICI-Induced Immune-Mediated Hepatitis

作　　者：白怡雪 袁瑞 张师容 郭卉[2] 刘梦洁[1] Bai Yixue;Yuan Rui;Zhang Shirong;Guo Hui;Liu Mengjie(Department of Medical Oncology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China;Institute of Bionic Engineering and Biomechanics,Xi'an Jiaotong University,Xian 710049,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院肿瘤内科,西安710061 [2]西安交通大学仿生工程与生物力学研究所,西安710049

出　　处：《肿瘤预防与治疗》2022年第9期835-841,共7页Journal of Cancer Control And Treatment

基　　金：西安交通大学基本科研业务费项目(编号:xzy012020059)。

摘　　要：免疫检查点抑制剂(immunecheckpointinhibitors,ICIs)通过阻断免疫抑制信号使T细胞重新激活并诱导其抗肿瘤活性。尽管ICIs为越来越多的患者带来了生存获益,但由于其破坏了自身免疫耐受,使得包括免疫检查点抑制剂相关性肝毒性(ICI-inducedimmune-mediatedhepatitis,IMH)在内的免疫相关不良事件成为不可忽视的临床问题。识别与解决IMH已成为医生和患者共同面临的问题。在这篇综述中,我们讨论了目前IMH的发生情况、危险因素及预测指标、临床病理学特征以及目前推荐的治疗方法,为临床上更好地管理IMH提供参考。Immune checkpoint inhibitors(ICIs) reactivate T cells and induce the antitumor activity by blocking immunosuppressive signals. Although ICIs have benefited the survival of an increasing number of patients, their disruption of autoimmune tolerance causes immune-related adverse events(irAEs), including ICI-induced immune-mediated hepatitis(IMH), a clinical problem that cannot be ignored. Identification and management of IMH has become a common problem for both physicians and patients. In this review, we discuss the current clinical information, risk factors and predictors, clinical presentation, pathological manifestations and management of IMH, providing promising hints for clinical management.

关 键 词：免疫检查点抑制剂 免疫相关不良事件 免疫检查点抑制剂相关性肝毒性 

分 类 号：R730.51[医药卫生—肿瘤]