免疫检查点抑制剂相关性胃肠道损伤的研究进展

免疫检查点抑制剂(immune checkpoint inhibitors,ICI)属于单克隆抗体,通过下调细胞毒性T淋巴细胞相关蛋白4(CTLA-4)或细胞程序性死亡受体1/配体1(PD-1/PD-L1)增强抗肿瘤免疫应答。ICI目前已被批准用于多种恶性肿瘤的治疗,其在转移性肿瘤中的疗效远远超过传统化疗。然而,ICI免疫治疗也会引起机体正常免疫耐受的缺失,导致免疫相关不良反应(immune-related adverse effects,irAEs),越来越多的irAEs被报道,其中胃肠道损伤为常见的不良反应,主要包括腹泻、结肠炎。ICI相关性结肠炎需要早诊断、早治疗,应视患者疾病分级给予止泻药物、糖皮质激素或英夫利昔单抗治疗。对于ICI相关性胃肠道损伤,目前还未发现有效的预防措施。

The advances on the study of immune checkpoint inhibitor-induced gastrointestinal in jury

Immune checkpoint inhibitors(ICIs)are monoclonal antibodies that enhance the anti-tumor immune response by downregulating cytotoxic T-lymphocyte antigen 4(CTLA-4),programmed cell death receptor 1,and programmed death-ligand 1(PD-1/PD-L1).ICIs have been approved for the treatment of various malignant tumors,and its efficacy rate in metastatic tumors is far higher than that of traditional chemotherapy.However,ICIs will also cause the deficiency of body’s normal immune tolerance and lead to immune-related adverse effects(irAEs).More and more irAEs have been described,affecting various organs including the gastrointestinal injury,mainly including diarrhea and colitis.ICI-induced colitis requires early diagnosis and early treatment.Antidiarrhea drugs,glucocorticoids or Infliximab should be given depending on the disease grade of patients.No effective preventive measures have been found for ICI-induced gastrointestinal injury.