Cappelli Laura C, Shah Ami A, Bingham Clifton O
Division of Rheumatology, Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Suite 1.B1, Baltimore, MD, USA.
Division of Rheumatology, Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Suite 1.B1, Baltimore, MD, USA.
Rheum Dis Clin North Am. 2017 Feb;43(1):65-78. doi: 10.1016/j.rdc.2016.09.007. Epub 2016 Oct 22.
Immune checkpoint inhibitors (ICIs) are increasingly studied and used as therapy for a growing number of malignancies. ICIs work by blocking inhibitory pathways of T-cell activation, leading to an immune response directed against tumors. Such nonspecific immunologic activation can lead to immune-related adverse events (IRAEs). Some IRAEs, including inflammatory arthritis, sicca syndrome, myositis, and vasculitis, are of special interest to rheumatologists. As use of ICIs increases, recognition of these IRAEs and developing treatment strategies will become important. In this review, the current literature on rheumatic and musculoskeletal IRAEs is summarized. The incidence, clinical presentations, and treatment considerations are highlighted.
免疫检查点抑制剂（ICIs）正越来越多地被研究并用于治疗越来越多的恶性肿瘤。ICIs通过阻断T细胞激活的抑制途径发挥作用，从而引发针对肿瘤的免疫反应。这种非特异性免疫激活可导致免疫相关不良事件（IRAEs）。一些IRAEs，包括炎性关节炎、干燥综合征、肌炎和血管炎，特别引起风湿病学家的关注。随着ICIs使用的增加，认识这些IRAEs并制定治疗策略将变得很重要。在这篇综述中，总结了关于风湿性和肌肉骨骼IRAEs的当前文献。重点介绍了发病率、临床表现和治疗注意事项。
