Endocrine immune-related adverse effects of immune-checkpoint inhibitors.

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM Expert Review of Endocrinology & Metabolism Pub Date : 2023-09-01 Epub Date: 2023-09-08 DOI:10.1080/17446651.2023.2256841

Viola Trevisani, Lorenzo Iughetti, Laura Lucaccioni, Barbara Predieri

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Abstract

Introduction: Immune-checkpoint inhibitor therapy modulates the response of the immune system acting against cancer. Two pathways impacted by this kind of treatment are the CTLA4 and the PD-1/PD-L1 pathways. ICI therapy can trigger autoimmune adverse effects, known as immune-related Adverse Events (irAEs).

Areas covered: This review focuses on irAEs which affect the endocrine system. This review elucidates the pathways used by these drugs with a focus on the hypothetical pathogenesis at their basis. In fact, the pathophysiology of irAEs concerns the possibility of an interaction between cellular autoimmunity, humoral immunity, cytokines, chemokines, and genetics. The endocrine irAEs examined are thyroid dysfunctions, immune related-hypophysitis, diabetes, peripheral adrenal insufficiency, and hypoparathyroidism.

Expert opinion: There is still much to investigate in endocrine irAES of checkpoint inhibitors. In the future, checkpoint inhibitors will be increasingly utilized therapies, and therefore it is crucial to find the proper diagnostic-therapeutic program for irAEs, especially as endocrine irAEs are nonreversible and require lifelong replacement therapies.

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免疫检查点抑制剂的内分泌免疫相关不良反应。

简介：免疫检查点抑制剂治疗调节免疫系统对癌症的反应。受这种治疗影响的两种途径是CTLA4和PD-1/PD-L1途径。ICI治疗可引发自身免疫性不良反应，称为免疫相关不良事件（irAE）。涵盖的领域：这篇综述的重点是影响内分泌系统的irAE。这篇综述阐明了这些药物使用的途径，重点是其基础上的假设发病机制。事实上，irAE的病理生理学涉及细胞自身免疫、体液免疫、细胞因子、趋化因子和遗传学之间相互作用的可能性。检查的内分泌irAE包括甲状腺功能异常、免疫相关垂体炎、糖尿病、外周肾上腺功能不全和甲状旁腺功能减退。专家意见：检查点抑制剂在内分泌irAES中仍有很多需要研究的地方。在未来，检查点抑制剂将越来越多地被用于治疗，因此，找到合适的irAE诊断治疗方案至关重要，尤其是因为内分泌irAE是不可逆的，需要终身替代治疗。

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来源期刊

Expert Review of Endocrinology & Metabolism ENDOCRINOLOGY & METABOLISM-

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4.80

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0.00%

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期刊介绍： Implicated in a plethora of regulatory dysfunctions involving growth and development, metabolism, electrolyte balances and reproduction, endocrine disruption is one of the highest priority research topics in the world. As a result, we are now in a position to better detect, characterize and overcome the damage mediated by adverse interaction with the endocrine system. Expert Review of Endocrinology and Metabolism (ISSN 1744-6651), provides extensive coverage of state-of-the-art research and clinical advancements in the field of endocrine control and metabolism, with a focus on screening, prevention, diagnostics, existing and novel therapeutics, as well as related molecular genetics, pathophysiology and epidemiology.