Department of Immunology and Microbiology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Ann N Y Acad Sci. 2010 Jan;1183:222-36. doi: 10.1111/j.1749-6632.2009.05138.x.
Rapid advances in our understanding of the immune network have led to treatment modalities for malignancies and autoimmune diseases based on modulation of the immune response. Yet therapeutic modulation has resulted in immune dysregulation and opportunistic autoimmune sequelae, despite prescreening efforts in clinical trials. This review focuses on recent clinical data on opportunistic autoimmune disorders arising from three immunotherapeutic modalities: (1) systemic immunomodulators, including interferon-alpha (also used to treat hepatitis C patients) and interferon-beta; (2) monoclonal antibodies to CTLA-4 and CD52, and (3) hematopoietic stem cell transplantation. Uncategorized predisposing factors in these patients include major histocompatibility complex and gender genetics, prevalence of different autoimmune diseases, prior chemotherapy, underlying disorder (e.g., hepatitis C), and preconditioning regimens as part of organ and stem cell transplants. Not unexpectedly, the prevalent autoimmune thyroid disease surfaced frequently. Our combination models to study the balance between thyroid autoimmunity and tumor immunity upon regulatory T-cell perturbation are briefly described.
免疫网络研究的快速进展，使得我们能够基于免疫反应的调节来治疗恶性肿瘤和自身免疫性疾病。然而，尽管在临床试验中进行了预筛选，治疗调节还是导致了免疫失调和机会性自身免疫后遗症。这篇综述主要关注三种免疫治疗方式引起的机会性自身免疫疾病的最新临床数据：（1）全身免疫调节剂，包括干扰素-α（也用于治疗丙型肝炎患者）和干扰素-β；（2）针对 CTLA-4 和 CD52 的单克隆抗体；（3）造血干细胞移植。这些患者中未分类的易患因素包括主要组织相容性复合体和性别遗传学、不同自身免疫性疾病的流行率、先前的化疗、基础疾病（如丙型肝炎）以及器官和干细胞移植的预处理方案。不出所料，常见的自身免疫性甲状腺疾病经常出现。我们简要描述了用于研究调节性 T 细胞扰动时甲状腺自身免疫与肿瘤免疫之间平衡的组合模型。
