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免疫检查点抑制剂相关不良反应机制的研究进展

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免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)所致的免疫相关不良反应(immune-related adverse events,irAE)大多数是由过度免疫针对正常器官引起的,其严重程度、发生时间及受累器官往往难以预测.不良反应可导致治疗延误或中断,并且在极少数情况下可能危及生命.发生irAE的机制主要与免疫细胞的紊乱、炎症因子表达失衡、自身抗体及补体改变、甚至肠道微生物失调等因素有关.然而,由于不同器官的结构、常驻免疫细胞的功能等存在差异,不同器官发生irAE的机制略有不同.未来的研究应重点关注根据不同器官发生irAE的机制,开发有针对性的预防或治疗irAE的药物.此外,加深对irAE发生机制的研究有助于临床医生更好地理解和掌握ICIs的使用,并为临床用药提供更好的指导.
Mechanism of immune checkpoint inhibitors related adverse events
Most immune-related adverse event(irAE)associated with immune checkpoint inhibitors(ICIs)resulted from excessive immune response against normal organs.The severity,timing,and organs affected by these events were often unpredictable.Adverse reactions could cause treatment delays or interruptions,in rare cases,pose a life-threatening risk.The mechanisms underlying irAE involved immune cell dysregulation,imbalances in inflammatory factor expression,alterations in autoantibodies and complement activation,even dysbiosis of intestinal microorganisms.However,the mechanisms of irAE occurrence might differ slightly among organs due to variations in their structures and the functions of resident immune cells.Future research should focus on the development of targeted drugs for the prevention or treatment of irAE based on the mechanisms by which irAE occurs in different organs.A deeper understanding of the mechanisms underlying irAE occurrence would aid clinicians in effectively utilizing ICIs and provide valuable guidance for their clinical application.

immune checkpoint inhibitorimmune-related adverse eventepidemiologypathogenic mechanism

章蔚、林华月

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中山大学孙逸仙纪念医院乳腺肿瘤中心(广州 510120)

免疫检查点抑制剂 免疫相关不良反应 流行病学 发病机制

广东省基础与应用基础研究基金联合基金

2020A1515110047

2024

中国普外基础与临床杂志
四川大学华西医院

中国普外基础与临床杂志

CSTPCD
影响因子:0.858
ISSN:1007-9424
年,卷(期):2024.31(1)
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