免疫介导的肝炎:基础知识与治疗

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY Revista de Gastroenterologia de Mexico Pub Date : 2024-01-01 DOI:10.1016/j.rgmx.2023.12.003
J.A. Velarde-Ruiz Velasco , D.K. Tapia Calderón , S. Cerpa-Cruz , J.A. Velarde-Chávez , J.F. Uribe Martínez , E.S. García Jiménez , J.M. Aldana Ledesma , Á. Díaz-González , J. Crespo
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引用次数: 0

摘要

免疫检查点抑制剂(ICIs)免疫疗法为晚期癌症治疗带来了革命性的变化。然而,这些药物的普遍使用导致免疫介导不良事件的发生率增加,而肝脏是最常受影响的器官之一。与免疫治疗相关的肝脏受累被称为免疫介导性肝炎(IMH),不同作者对其发生率和临床特征进行了描述。免疫介导性肝炎通常表现为转氨酶水平轻度升高,可在常规血液检查中看到,并可自行恢复正常,但也可表现为严重的转氨酶炎,可能导致永久性中断治疗。以下综述旨在描述有关免疫介导性肝炎的流行病学、诊断、风险因素和进展的最新概念,以及其在不同类型常见癌症(包括肝细胞癌)中的发病率。本文还根据最新指南提供了治疗建议。
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Hepatitis inmunomediada: conceptos básicos y tratamiento

Immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized advanced cancer management. Nevertheless, the generalized use of these medications has led to an increase in the incidence of adverse immune-mediated events and the liver is one of the most frequently affected organs.

Liver involvement associated with the administration of immunotherapy is known as immune-mediated hepatitis (IMH), whose incidence and clinical characteristics have been described by different authors. It often presents as mild elevations of aminotransferase levels, seen in routine blood tests, that spontaneously return to normal, but it can also manifest as severe transaminitis, possibly leading to the permanent discontinuation of treatment.

The aim of the following review was to describe the most up-to-date concepts regarding the epidemiology, diagnosis, risk factors, and progression of IMH, as well as its incidence in different types of common cancers, including hepatocellular carcinoma. Treatment recommendations according to the most current guidelines are also provided.

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来源期刊
Revista de Gastroenterologia de Mexico
Revista de Gastroenterologia de Mexico GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
1.60
自引率
12.50%
发文量
102
审稿时长
12 weeks
期刊介绍: La Revista de Gastroenterología de México es el órgano oficial de la Asociación Mexicana de Gastroenterología. Sus espacios están abiertos a los miembros de la Asociación como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos, cumpliendo con las políticas editoriales que a continuación se mencionan. El objetivo principal de la Revista de Gastroenterología de México, es publicar trabajos originales del amplio campo de la gastroenterología, así como proporcionar información actualizada y relevante para el área de la especialidad y áreas afines. Los trabajos científicos incluyen las áreas de Gastroenterología clínica, endoscópica, quirúrgica y pediátrica.
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