皮肤不良反应作为免疫检查点抑制剂治疗的挑战:研究进展与未来方向  

Research Progress and Future Directions on Cutaneous Adverse Event in Immune Checkpoint Inhibitors

作　　者：王燕 左亚刚 WANG Yan;ZUO Yagang(Department of Dermatology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,State Key Laboratory of Complex Severe and Rare Diseases,National Clinical Research Center for Dermatologic and Immunologic Diseases,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院皮肤科,疑难重症及罕见病国家重点实验室,国家皮肤与免疫疾病临床医学研究中心,北京100730

出　　处：《中国皮肤性病学杂志》2024年第12期1305-1311,共7页The Chinese Journal of Dermatovenereology

基　　金：中央高水平医院临床科研业务费项目(2022-PUMCH-B-092)。

摘　　要：近年来,免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)已成为治疗癌症的重要手段。然而,随着临床应用的增加,其在激活免疫系统攻击肿瘤细胞的同时,也导致了免疫系统的过度激活,进而引发一系列免疫相关不良反应(immune-related adverse events,irAEs)。其中,免疫相关皮肤不良反应(immune-related cutaneous adverse events,irCAEs)最常见,严重时可危及生命。irCAEs的具体机制尚不清楚,其可表现为非特异性斑丘疹、苔癣样皮炎、白癜风、银屑病、大疱性皮病等多种形式。本文探讨irCAEs的潜在机制、临床类型、诊断与评估方法、治疗以及预测irCAEs发生的生物标志物的研究进展,旨在提高对irCAEs的认识和管理水平,为患者带来更多益处。In recent years,Immune checkpoint inhibitors(ICIs)have emerged as a critical therapeutic approach for the treatment of multiple cancers.However,with the broader clinical application,ICIs are recognized to not only facilitate the immune system′s attack on tumor cells but also potentially lead to the over activation of the immune system,causing a range of immune-related adverse events(irAEs).Among these,immune-related cutaneous adverse events(irCAEs)are the most frequently encountered,and they can be severe enough to endanger life.The precise mechanisms underlying irCAEs are not fully elucidated.irCAEs may present as maculopapular rashes,lichenoid eruptions,vitiligo,psoriasis,immunobullous disorders and other diverse forms.This article aims to delve into the potential pathogenic mechanisms,clinical manifestations,diagnostic and assessment strategies,treatment guidelines,and the investigation of biomarkers for predicting the onset of irCAEs.The purpose is to enhance the understanding and management level of irCAEs and bring more benefits to patients.

关 键 词：免疫检查点抑制剂 免疫相关不良反应 免疫相关皮肤不良反应 生物标志物 

分 类 号：R751[医药卫生—皮肤病学与性病学] R730.51[医药卫生—临床医学]