Pub Date : 2025-11-26DOI: 10.1016/j.lpm.2025.104334
Maxence Rateaux , Dominique Bremond-Gignac , Matthieu P. Robert
Albinism is a heterogeneous disorder characterized by both dermatological and ophthalmological expressions. In ophthalmological practice, patients with albinism frequently present with nystagmus and reduced visual acuity, the diagnosis having been made previously on dermatological features, or not. Specific ophthalmological features include iris transillumination, macular hypopigmentation, and foveal hypoplasia, all of them being quantifiable clinically using reproducible grading systems. Refractive errors (most often with-the-rule astigmatism and hypermetropia), along with strabismus (both eso- and exotropia), are also commonly encountered. Anatomical anomaly of the visual pathway, specifically chiasmal misrouting of retinal fibers, is a consistent finding. It potentially results in the presence of an abnormal angle lambda, which can manifest as a pseudo-exotropia appearance. The identification and quantification of all clinical signs allow to fully characterize the patient’s phenotype, and often to make the diagnosis of albinism, from infancy to adulthood.
The first step of the ophthalmological management in children consists in screening for amblyopia or amblyogenic factors (such as strabismus and refractive errors). Subsequently, management is typically divided into three key categories. Improvement of visual acuity through cycloplegic refraction and prescription of full optical correction (via spectacles or contact lenses). Management of infantile nystagmus syndrome, which can sometimes benefit from contact lenses, prisms, or surgical interventions. Tailored visual rehabilitation by prescribing spectral filter spectacles and low-vision aids whenever needed.
{"title":"Albinism: Management and care of ophthalmological manifestations","authors":"Maxence Rateaux , Dominique Bremond-Gignac , Matthieu P. Robert","doi":"10.1016/j.lpm.2025.104334","DOIUrl":"10.1016/j.lpm.2025.104334","url":null,"abstract":"<div><div>Albinism is a heterogeneous disorder characterized by both dermatological and ophthalmological expressions. In ophthalmological practice, patients with albinism frequently present with nystagmus and reduced visual acuity, the diagnosis having been made previously on dermatological features, or not. Specific ophthalmological features include iris transillumination, macular hypopigmentation, and foveal hypoplasia, all of them being quantifiable clinically using reproducible grading systems. Refractive errors (most often with-the-rule astigmatism and hypermetropia), along with strabismus (both eso- and exotropia), are also commonly encountered. Anatomical anomaly of the visual pathway, specifically chiasmal misrouting of retinal fibers, is a consistent finding. It potentially results in the presence of an abnormal angle lambda, which can manifest as a pseudo-exotropia appearance. The identification and quantification of all clinical signs allow to fully characterize the patient’s phenotype, and often to make the diagnosis of albinism, from infancy to adulthood.</div><div>The first step of the ophthalmological management in children consists in screening for amblyopia or amblyogenic factors (such as strabismus and refractive errors). Subsequently, management is typically divided into three key categories. Improvement of visual acuity through cycloplegic refraction and prescription of full optical correction (via spectacles or contact lenses). Management of infantile nystagmus syndrome, which can sometimes benefit from contact lenses, prisms, or surgical interventions. Tailored visual rehabilitation by prescribing spectral filter spectacles and low-vision aids whenever needed.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 3","pages":"Article 104334"},"PeriodicalIF":3.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although it has been described for a long time, albinism remains poorly understood in many aspects. The clinical presentation is very different between subtypes of the disease and even within a single subtype. The monogenic nature of the disease is increasingly questioned. What are the functions of the proteins encoded by the genes involved in the disease and what are the pathophysiological consequences of their alteration? What is the link between defective melanogenesis and dysfunction of the neural retina? This review relates to the most recent advances in the field of albinism. As it is not possible to cover all aspects of the disease in an exhaustive way, we focus here on a selection of aspects that seem most relevant to understanding the disease and for patients’ caretaking. These are: epidemiology, genetics, clinical characterization, cell biology and pathophysiology, psycho-sociology, therapeutic education, and therapeutic approaches.
{"title":"Recent advances in albinism","authors":"Fanny Morice-Picard , Modibo Diallo , Benoit Arveiler","doi":"10.1016/j.lpm.2025.104332","DOIUrl":"10.1016/j.lpm.2025.104332","url":null,"abstract":"<div><div>Although it has been described for a long time, albinism remains poorly understood in many aspects. The clinical presentation is very different between subtypes of the disease and even within a single subtype. The monogenic nature of the disease is increasingly questioned. What are the functions of the proteins encoded by the genes involved in the disease and what are the pathophysiological consequences of their alteration? What is the link between defective melanogenesis and dysfunction of the neural retina? This review relates to the most recent advances in the field of albinism. As it is not possible to cover all aspects of the disease in an exhaustive way, we focus here on a selection of aspects that seem most relevant to understanding the disease and for patients’ caretaking. These are: epidemiology, genetics, clinical characterization, cell biology and pathophysiology, psycho-sociology, therapeutic education, and therapeutic approaches.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 3","pages":"Article 104332"},"PeriodicalIF":3.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1016/j.lpm.2025.104333
Modibo Diallo, Laura Salavessa, Benoit Arveiler, Cédric Delevoye
Albinism classically encompasses several forms: oculocutaneous (OCA), ocular (OA1 and Foveal hypoplasia optic nerve decussation defect anterior segment dysgenesis syndrome [FHONDA]), and syndromic (Hermansky-Pudlak syndrome [HPS], Chediak-Higashi syndrome [CHS]), with all being autosomal recessive except X-linked recessive OA1. Twenty-one genes are identified to date, with OCA1 being most common in Europeans or patients of European descent and OCA2 in Sub-Saharan Africans. Their sequencing provides a diagnostic rate of ∼70 %, though unresolved cases may arise from variants in poorly explored non-coding regions, undetected genes, or differential diagnoses. The cellular and molecular mechanisms underlying non-syndromic forms of albinism affect the ability of pigment cells to synthesize melanin pigments in melanosomes, mainly through defects in melanogenic enzymes, or in ion channels or transporters affecting melanosome pH regulation. In contrast, syndromic forms of albinism (e.g., HPS subtypes) are membrane trafficking disorders caused by mutations in multi-subunit protein complexes (e.g., BLOC1, BLOC2, BLOC3, or AP-3) targeting the formations and functions of certain lysosome-related organelles (LROs), of which the melanosome is a prototypical member. Integrating clinical, genetic and fundamental research is essential for a comprehensive understanding of albinism, from patient manifestations to identifying molecular targets and elucidating their cell and tissue-specific functions, ultimately paving the way for improved diagnostics and therapeutic strategies.
{"title":"Albinism: from genetics to cell biology and physiopathology.","authors":"Modibo Diallo, Laura Salavessa, Benoit Arveiler, Cédric Delevoye","doi":"10.1016/j.lpm.2025.104333","DOIUrl":"10.1016/j.lpm.2025.104333","url":null,"abstract":"<p><p>Albinism classically encompasses several forms: oculocutaneous (OCA), ocular (OA1 and Foveal hypoplasia optic nerve decussation defect anterior segment dysgenesis syndrome [FHONDA]), and syndromic (Hermansky-Pudlak syndrome [HPS], Chediak-Higashi syndrome [CHS]), with all being autosomal recessive except X-linked recessive OA1. Twenty-one genes are identified to date, with OCA1 being most common in Europeans or patients of European descent and OCA2 in Sub-Saharan Africans. Their sequencing provides a diagnostic rate of ∼70 %, though unresolved cases may arise from variants in poorly explored non-coding regions, undetected genes, or differential diagnoses. The cellular and molecular mechanisms underlying non-syndromic forms of albinism affect the ability of pigment cells to synthesize melanin pigments in melanosomes, mainly through defects in melanogenic enzymes, or in ion channels or transporters affecting melanosome pH regulation. In contrast, syndromic forms of albinism (e.g., HPS subtypes) are membrane trafficking disorders caused by mutations in multi-subunit protein complexes (e.g., BLOC1, BLOC2, BLOC3, or AP-3) targeting the formations and functions of certain lysosome-related organelles (LROs), of which the melanosome is a prototypical member. Integrating clinical, genetic and fundamental research is essential for a comprehensive understanding of albinism, from patient manifestations to identifying molecular targets and elucidating their cell and tissue-specific functions, ultimately paving the way for improved diagnostics and therapeutic strategies.</p>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":" ","pages":"104333"},"PeriodicalIF":3.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-23DOI: 10.1016/j.lpm.2025.104329
Cédric Mahiat, Jacques Cadranel, Vincent Fallet, Constance Meteye, Sébastien Gendarme, Jérémy Slomka, Anthony Canellas
Immune checkpoint inhibitor-related pneumonitis (ICI-P) is an uncommon but serious immune-related adverse event, representing the leading cause of treatment-related mortality among patients receiving immune checkpoint inhibitors (ICIs). Prompt recognition and effective management are therefore critical. This review summarizes current data on the epidemiology, clinical and radiological features of ICI-P, and offers practical recommendations for its management, including considerations for ICI rechallenge. Particular attention is given to high-risk populations, such as patients with prior thoracic radiotherapy or underlying interstitial lung disease.
{"title":"Pulmonary toxicity of immune-checkpoint inhibitors","authors":"Cédric Mahiat, Jacques Cadranel, Vincent Fallet, Constance Meteye, Sébastien Gendarme, Jérémy Slomka, Anthony Canellas","doi":"10.1016/j.lpm.2025.104329","DOIUrl":"10.1016/j.lpm.2025.104329","url":null,"abstract":"<div><div>Immune checkpoint inhibitor-related pneumonitis (ICI-P) is an uncommon but serious immune-related adverse event, representing the leading cause of treatment-related mortality among patients receiving immune checkpoint inhibitors (ICIs). Prompt recognition and effective management are therefore critical. This review summarizes current data on the epidemiology, clinical and radiological features of ICI-P, and offers practical recommendations for its management, including considerations for ICI rechallenge. Particular attention is given to high-risk populations, such as patients with prior thoracic radiotherapy or underlying interstitial lung disease.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104329"},"PeriodicalIF":3.4,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-22DOI: 10.1016/j.lpm.2025.104328
Maria Ortega Abad, Ricardo Correa
The use of immune checkpoint inhibitors in cancer therapy has increased throughout the years and will continue in the future. These drugs have shown groundbreaking survival improvements in patients with different types of cancer and are being studied in many clinical trials. Therefore, their side effects will continue to be a concern for clinicians. Endocrine immune related adverse effects (irAEs) are particularly important because of their permanent damage, need of livelong therapy and severe acute presentations. The aim of this review is to present updated information on endocrine immune related adverse effects (irAEs).
{"title":"Adverse effects of immune checkpoint inhibitors in the endocrine system","authors":"Maria Ortega Abad, Ricardo Correa","doi":"10.1016/j.lpm.2025.104328","DOIUrl":"10.1016/j.lpm.2025.104328","url":null,"abstract":"<div><div>The use of immune checkpoint inhibitors in cancer therapy has increased throughout the years and will continue in the future. These drugs have shown groundbreaking survival improvements in patients with different types of cancer and are being studied in many clinical trials. Therefore, their side effects will continue to be a concern for clinicians. Endocrine immune related adverse effects (irAEs) are particularly important because of their permanent damage, need of livelong therapy and severe acute presentations. The aim of this review is to present updated information on endocrine immune related adverse effects (irAEs).</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104328"},"PeriodicalIF":3.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-22DOI: 10.1016/j.lpm.2025.104330
Davide Fattore , Giuseppe Lauletta , Cecile Pages , Valentine Theret , Vincent Sibaud
The use of immune checkpoint inhibitors (ICIs) has emerged as a transformative approach in the treatment of various malignancies. ICIs target immune regulatory pathways—specifically cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death-1 (PD-1), and programmed death-ligand 1 (PD-L1)—to reinvigorate anti-tumor immune responses. However, these therapies can induce immune-related adverse events (irAEs) due to systemic immune activation and loss of tolerance. Among the most common irAEs are those affecting the skin, manifesting as a spectrum of cutaneous autoimmune reactions. These range from self-limiting reactions (i.e. eczema-like reactions, psoriasis, lichenoid reactions, vitiligo) to severe and potentially life-threatening conditions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or autoimmune blistering diseases. Cutaneous irAEs can significantly affect a patient's quality of life and may necessitate dose adjustments or permanent discontinuation of life-prolonging therapies. Importantly, some skin toxicities may correlate with favorable anti-tumor responses. This article comprehensively reviews epidemiology, pathophysiology, clinical presentations, including rare and emerging patterns, diagnostic strategies, management protocols, and future directions in the understanding and treatment of cutaneous irAEs induced by immunotherapy.
{"title":"Update on dermatological toxicities of immune checkpoint inhibitors","authors":"Davide Fattore , Giuseppe Lauletta , Cecile Pages , Valentine Theret , Vincent Sibaud","doi":"10.1016/j.lpm.2025.104330","DOIUrl":"10.1016/j.lpm.2025.104330","url":null,"abstract":"<div><div>The use of immune checkpoint inhibitors (ICIs) has emerged as a transformative approach in the treatment of various malignancies. ICIs target immune regulatory pathways—specifically cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death-1 (PD-1), and programmed death-ligand 1 (PD-L1)—to reinvigorate anti-tumor immune responses. However, these therapies can induce immune-related adverse events (irAEs) due to systemic immune activation and loss of tolerance. Among the most common irAEs are those affecting the skin, manifesting as a spectrum of cutaneous autoimmune reactions. These range from self-limiting reactions (i.e. eczema-like reactions, psoriasis, lichenoid reactions, vitiligo) to severe and potentially life-threatening conditions such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), or autoimmune blistering diseases. Cutaneous irAEs can significantly affect a patient's quality of life and may necessitate dose adjustments or permanent discontinuation of life-prolonging therapies. Importantly, some skin toxicities may correlate with favorable anti-tumor responses. This article comprehensively reviews epidemiology, pathophysiology, clinical presentations, including rare and emerging patterns, diagnostic strategies, management protocols, and future directions in the understanding and treatment of cutaneous irAEs induced by immunotherapy.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104330"},"PeriodicalIF":3.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-22DOI: 10.1016/j.lpm.2025.104331
Rakiba Belkhir , Marjolaine Gosset , Antoine Rousseau , Samuel Bitoun , Thierry Lazure , Xavier Mariette , Gaetane Nocturne
Background
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with immune-related adverse events (irAEs), including sicca syndrome. This condition, characterized by ocular and oral dryness, is under-recognized yet significantly impacts patients' quality of life.
Objectives
This review aims to highlight the prevalence, clinical features, and management strategies for ICI-induced sicca syndrome, emphasizing its distinction from Sjögren disease (SjD) and the importance of early detection and treatment.
Key points
Sicca induced by immune checkpoint inhibitors (ICI) is under-estimated but might affect 5 to 24 % of the patients treated by ICI. The pathophysiology of ICI-induced sicca is different from SjD, with infiltration of salivary glands mainly by T lymphocytes. Management of sicca induced by ICI consists of a graded approach, including symptomatic treatment and corticosteroids.
Future directions
Future research on ICI-induced sicca syndrome should focus on prospective studies to accurately determine its frequency and validate screening tools for early diagnosis. Assessing the benefits of early immunomodulatory treatments and exploring the long-term outcome of the condition are also essential. Understanding the immunological mechanisms and risk factors will be crucial to improve the management. Collaboration among specialists is mandatory to develop comprehensive management guidelines and improving patient condition.
{"title":"Sicca induced by immune checkpoint inhibitors","authors":"Rakiba Belkhir , Marjolaine Gosset , Antoine Rousseau , Samuel Bitoun , Thierry Lazure , Xavier Mariette , Gaetane Nocturne","doi":"10.1016/j.lpm.2025.104331","DOIUrl":"10.1016/j.lpm.2025.104331","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with immune-related adverse events (irAEs), including sicca syndrome. This condition, characterized by ocular and oral dryness, is under-recognized yet significantly impacts patients' quality of life.</div></div><div><h3>Objectives</h3><div>This review aims to highlight the prevalence, clinical features, and management strategies for ICI-induced sicca syndrome, emphasizing its distinction from Sjögren disease (SjD) and the importance of early detection and treatment.</div></div><div><h3>Key points</h3><div>Sicca induced by immune checkpoint inhibitors (ICI) is under-estimated but might affect 5 to 24 % of the patients treated by ICI. The pathophysiology of ICI-induced sicca is different from SjD, with infiltration of salivary glands mainly by T lymphocytes. Management of sicca induced by ICI consists of a graded approach, including symptomatic treatment and corticosteroids.</div></div><div><h3>Future directions</h3><div>Future research on ICI-induced sicca syndrome should focus on prospective studies to accurately determine its frequency and validate screening tools for early diagnosis. Assessing the benefits of early immunomodulatory treatments and exploring the long-term outcome of the condition are also essential. Understanding the immunological mechanisms and risk factors will be crucial to improve the management. Collaboration among specialists is mandatory to develop comprehensive management guidelines and improving patient condition.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104331"},"PeriodicalIF":3.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-21DOI: 10.1016/j.lpm.2025.104326
Franck Carbonnel , Antoine Martin , Lysiane Marthey , Christophe Bellanger , Rita Bou-Farah , Isabelle Boytchev , Raef Abdallah , Aurélien Amiot , Antoine Meyer
Immune checkpoint inhibitors (ICI) have improved the prognosis of several cancers. ICI enhance T-cell activation, and therefore stimulate anti-cancer immunity, but also cause immune related adverse effects (irAE), including those affecting the gastrointestinal (GI) tract. GI-irAE are observed in 7 to 30 % of patients treated with ICI. With extending indications of ICI, oncologists, gastroenterologists and primary-care physicians face an increasing number of patients with ICI-induced GI-irAE. This paper summarizes incidence, risk factors, clinical manifestations and management of GI-irAE. Current management of patients with GI IrAE should include refutation of differential diagnoses, assessment of severity, corticosteroids and rapid introduction of infliximab in non-responders.
{"title":"Gastrointestinal complications of immune checkpoint Inhibitor therapy","authors":"Franck Carbonnel , Antoine Martin , Lysiane Marthey , Christophe Bellanger , Rita Bou-Farah , Isabelle Boytchev , Raef Abdallah , Aurélien Amiot , Antoine Meyer","doi":"10.1016/j.lpm.2025.104326","DOIUrl":"10.1016/j.lpm.2025.104326","url":null,"abstract":"<div><div>Immune checkpoint inhibitors (ICI) have improved the prognosis of several cancers. ICI enhance T-cell activation, and therefore stimulate anti-cancer immunity, but also cause immune related adverse effects (irAE), including those affecting the gastrointestinal (GI) tract. GI-irAE are observed in 7 to 30 % of patients treated with ICI. With extending indications of ICI, oncologists, gastroenterologists and primary-care physicians face an increasing number of patients with ICI-induced GI-irAE. This paper summarizes incidence, risk factors, clinical manifestations and management of GI-irAE. Current management of patients with GI IrAE should include refutation of differential diagnoses, assessment of severity, corticosteroids and rapid introduction of infliximab in non-responders.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104326"},"PeriodicalIF":3.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-21DOI: 10.1016/j.lpm.2025.104327
Maria Sol Andres, Maria Clara Llamedo, Sivatharshini Ramalingam, Alexander R. Lyon
The advent of immune checkpoint inhibitors (ICIs) has revolutionized cancer therapy, offering improved survival outcomes in various malignancies. However, their use is associated with immune-related adverse events (irAEs), including severe cardiovascular complications. Initially considered a rare and highly fatal condition, ICI-related myocarditis was first recognized in 2016, when Johnson et al. reported an incidence of 0.09 % with 50 % mortality among patients treated with ICIs. Over time, growing awareness, early detection, and advancements in treatment have led to a significant reduction in mortality, with recent studies reporting rates as low as 7 % and lower. Importantly, it is now recognized that myocarditis is not the only cardiovascular adverse event (CVAE) related to ICIs. The spectrum of CVAEs has expanded to include conditions such as pericarditis, non-inflammatory left ventricular dysfunction, acute coronary syndrome, and arrhythmias, among others. This review aims to provide an overview of the current understanding of ICI-mediated cardiovascular adverse effects, highlighting diagnostic challenges, therapeutic strategies, and future directions for research.
{"title":"Immunotherapy and the heart: Understanding the cardiovascular risks of immune checkpoint inhibitors","authors":"Maria Sol Andres, Maria Clara Llamedo, Sivatharshini Ramalingam, Alexander R. Lyon","doi":"10.1016/j.lpm.2025.104327","DOIUrl":"10.1016/j.lpm.2025.104327","url":null,"abstract":"<div><div>The advent of immune checkpoint inhibitors (ICIs) has revolutionized cancer therapy, offering improved survival outcomes in various malignancies. However, their use is associated with immune-related adverse events (irAEs), including severe cardiovascular complications. Initially considered a rare and highly fatal condition, ICI-related myocarditis was first recognized in 2016, when Johnson et al. reported an incidence of 0.09 % with 50 % mortality among patients treated with ICIs. Over time, growing awareness, early detection, and advancements in treatment have led to a significant reduction in mortality, with recent studies reporting rates as low as 7 % and lower. Importantly, it is now recognized that myocarditis is not the only cardiovascular adverse event (CVAE) related to ICIs. The spectrum of CVAEs has expanded to include conditions such as pericarditis, non-inflammatory left ventricular dysfunction, acute coronary syndrome, and arrhythmias, among others. This review aims to provide an overview of the current understanding of ICI-mediated cardiovascular adverse effects, highlighting diagnostic challenges, therapeutic strategies, and future directions for research.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104327"},"PeriodicalIF":3.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-09DOI: 10.1016/j.lpm.2025.104316
Christopher B. Bosma, Wassim W. Labaki, MeiLan K. Han
Background and Objectives
The ability to identify individuals at risk for progression to chronic obstructive pulmonary disease (COPD) remains challenging. The concept of pre-COPD has been proposed as a framework to identify patients without current airflow obstruction at greatest risk for progression to COPD using a constellation of symptoms, physiologic changes, and structural changes on chest imaging. While multiple biomarkers are linked to the subsequent development of COPD in at-risk individuals, no single biomarker has emerged as the best predictor. The goal of this review is to define the concept of pre-COPD, summarize known biomarkers associated with later development of COPD, and address the impact of pre-COPD on patient care.
Methods
Narrative Review
Conclusion
The concept of pre-COPD can help meet current gaps in screening and care for patients at risk of progression to COPD. A framework definition of pre-COPD allows for identification of individuals at risk for progression to COPD and indicates increased morbidity and mortality. While the ideal biomarker for pre-COPD has not been identified, multimodal risk prediction scores and practical clinical definitions are emerging for use in clinical practice. Additional research is needed to better understand optimal clinical screening and management of patients with pre-COPD.
{"title":"Pre-COPD: Impact on prevention, detection, and treatment","authors":"Christopher B. Bosma, Wassim W. Labaki, MeiLan K. Han","doi":"10.1016/j.lpm.2025.104316","DOIUrl":"10.1016/j.lpm.2025.104316","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>The ability to identify individuals at risk for progression to chronic obstructive pulmonary disease (COPD) remains challenging. The concept of pre-COPD has been proposed as a framework to identify patients without current airflow obstruction at greatest risk for progression to COPD using a constellation of symptoms, physiologic changes, and structural changes on chest imaging. While multiple biomarkers are linked to the subsequent development of COPD in at-risk individuals, no single biomarker has emerged as the best predictor. The goal of this review is to define the concept of pre-COPD, summarize known biomarkers associated with later development of COPD, and address the impact of pre-COPD on patient care.</div></div><div><h3>Methods</h3><div>Narrative Review</div></div><div><h3>Conclusion</h3><div>The concept of pre-COPD can help meet current gaps in screening and care for patients at risk of progression to COPD. A framework definition of pre-COPD allows for identification of individuals at risk for progression to COPD and indicates increased morbidity and mortality. While the ideal biomarker for pre-COPD has not been identified, multimodal risk prediction scores and practical clinical definitions are emerging for use in clinical practice. Additional research is needed to better understand optimal clinical screening and management of patients with pre-COPD.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 1","pages":"Article 104316"},"PeriodicalIF":3.4,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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