Izzedine Hassane, Gueutin Victor, Gharbi Chems, Mateus Christine, Robert Caroline, Routier Emilie, Thomas Marina, Baumelou Alain, Rouvier Philippe
Department of Nephrology, Pitie-Salpetriere, 47-80 Boulevard de l'Hôpital, 75013, Paris, France,
Invest New Drugs. 2014 Aug;32(4):769-73. doi: 10.1007/s10637-014-0092-7. Epub 2014 Apr 1.
Monoclonal antibodies directed against the immune checkpoint protein cytotoxic T-lymphocyte antigen-4 (CTLA-4; CD152) have been investigated in metastatic melanoma and other cancers and have shown promising results. Inhibition of CTLA-4 characteristically induces well-known side effects called "immune-related adverse events" (irAEs). IrAEs mainly include colitis, dermatitis, hepatitis, endocrinopathies; uveitis, iridocyclitis, neuropathies, and inflammatory myopathy have occasionally been reported. Kidney involvement is rare. We report 2 cases of acute granulomatous interstitial nephritis and present, based on literature review, renal disorders related to Ipilimumab therapy. Autoimmune symptoms have to be carefully checked for patients treated with CTLA-4 inhibitors. In order to reduce the risk of sequelae, early recognition of irAEs and treatment initiation are crucial.
针对免疫检查点蛋白细胞毒性T淋巴细胞抗原4（CTLA-4；CD152）的单克隆抗体已在转移性黑色素瘤和其他癌症中进行了研究，并显示出有前景的结果。抑制CTLA-4通常会引发被称为“免疫相关不良事件”（irAEs）的众所周知的副作用。irAEs主要包括结肠炎、皮炎、肝炎、内分泌病；葡萄膜炎、虹膜睫状体炎、神经病变和炎性肌病偶尔也有报道。肾脏受累情况罕见。我们报告2例急性肉芽肿性间质性肾炎，并基于文献综述介绍与伊匹单抗治疗相关的肾脏疾病。对于接受CTLA-4抑制剂治疗的患者，必须仔细检查其自身免疫症状。为了降低后遗症风险，早期识别irAEs并开始治疗至关重要。
