免疫检查点抑制剂治疗期间并发肺孢子菌感染:两例病例报道并文献复习  

Pneumocystis jirovecii infection during immune checkpoint inhibitor therapy:a report of two cases and review of literature

作　　者：刘中安 陈叶珊[1] 黄艾[1] 李贵玲[1] LIU Zhong’an;CHEN Yeshan;HUANG Ai;LI Guiling(The Tumor Center,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430021,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属协和医院肿瘤中心,湖北武汉430021

出　　处：《肿瘤药学》2023年第1期127-132,共6页Anti-Tumor Pharmacy

摘　　要：近年来,免疫检查点抑制剂(ICI)在临床中广泛应用,给肿瘤患者带来了比放疗、化疗更进一步的生存获益。然而,在免疫抑制剂增强细胞免疫抗肿瘤的同时,也有可能增强机体正常的免疫反应,导致机体免疫耐受紊乱,引起相应器官出现不适症状,称之为免疫相关不良反应。其中,免疫相关性肺炎往往较难诊断,严重者可致命。肺孢子菌肺炎(PCP)作为一种机会性真菌感染性疾病,常发生于免疫力低下人群。鉴于ICIs对免疫功能的促进作用,目前的主要观点认为,肿瘤免疫治疗并不会增加肺孢子菌感染的机会。本文报道了两例免疫治疗期间发生肺孢子菌感染的病例,以期进一步加深人们对免疫相关性肺炎及PCP的认识。In recent years,the widespread use of immune checkpoint inhibitors(ICIs)in clinic practice has brought further survival benefits to tumor patients than traditional radiotherapy and chemotherapy.However,while immunosuppressants enhance cellular immunity against tumors,they may also enhance the normal immune response of the body,leading to immune tolerance disorders and causing discomfort in corresponding organs,which is called immune-related adverse events.Of them,immune-related pneumonia is often more difficult to diagnose and can be fatal in severe cases.Pneumocystis pneumonia(PCP),an opportunistic fungal infectious disease,often occurs in immunocompromised populations.Given the immune-promoting effect of ICIs,the current main view is that immunotherapy of tumors does not increase the chance of Pneumocystis infection.Here,we reported two patients who developed Pneumocystis jirovecii infection during immunotherapy,in order to further enhance our understanding of immune-related pneumonia and PCP.

关 键 词：免疫检查点抑制剂 免疫治疗 肺孢子菌 肺孢子菌肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]