Update on Immune Checkpoint Inhibitor Enterocolitis.

Q1 Medicine Current Gastroenterology Reports Pub Date : 2022-12-01 Epub Date: 2022-10-20 DOI:10.1007/s11894-022-00852-7

Molly R Kelly-Goss, Yousef R Badran, Michael Dougan

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Abstract

Purpose of review: Immune checkpoint inhibitor (ICI) therapy revolutionized the treatment of multiple solid and hematologic malignancies. Yet, with it came profound inflammatory toxicities that mimic autoimmune diseases, termed immune-related adverse events (irAEs). Prominent among these is gastrointestinal inflammation, including a spectrum of gastritis, enteritis, and colitis. Here we synthesize an approach to immune checkpoint related enterocolitis (irEC) - including diagnostics and therapeutics - underpinned by new insights into the mechanism behind these phenomena.

Recent findings: This review presents updated insights on how to approach irEC, including novel approaches to selective immunosuppressive therapy, the role of fecal microbiota transplant, and the underlying cellular mechanisms of irEC. This review provides an update on irEC diagnosis and therapy, with considerations of new therapies and special patient populations. The field of gastrointestinal irAEs requires additional investigation, which will ultimately provide the tools required for patients to continue to receive life-saving ICI therapy.

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免疫检查点抑制剂肠炎的最新进展。

综述的目的：免疫检查点抑制剂（ICI）疗法彻底改变了多种实体肿瘤和血液系统恶性肿瘤的治疗方法。然而，随之而来的是模仿自身免疫性疾病的严重炎症毒性，即免疫相关不良事件（irAEs）。其中最突出的是胃肠道炎症，包括一系列胃炎、肠炎和结肠炎。在此，我们总结了免疫检查点相关小肠结肠炎（irEC）的治疗方法，包括诊断和治疗方法，其基础是对这些现象背后机理的新认识：本综述介绍了如何处理irEC的最新见解，包括选择性免疫抑制疗法的新方法、粪便微生物群移植的作用以及irEC的潜在细胞机制。本综述提供了有关虹膜睫状体病变诊断和治疗的最新信息，并考虑了新疗法和特殊患者群体。胃肠道irAEs领域需要更多的研究，这最终将为患者继续接受挽救生命的 ICI 治疗提供所需的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Gastroenterology Reports Medicine-Gastroenterology

CiteScore

7.80

自引率

0.00%

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期刊介绍： As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.

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