Department of Nephrology, Monceau Park International Clinic Paris, France.
Department of Oncology, Gustave Roussy Institute, Villejuif, France.
Nephrol Dial Transplant. 2017 Jun 1;32(6):936-942. doi: 10.1093/ndt/gfw382.
Recent advances in immune checkpoint inhibitor (ICPI) development have led to major improvements in oncology patient outcomes. Cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1) are two essential immune checkpoint receptors. Ipilimumab and tremelimumab (anti-CTLA-4-blocking antibodies) and pembrolizumab and nivolumab (antibodies targeting PD-1 receptors) have already been approved by US Food and Drug Administration in several malignancies. Two different forms of ICPI-induced renal damage have been identified, including acute (granulomatous) tubulointerstitial nephritis and immune complex glomerulonephritis. The observed acute renal damage can be reversed upon ICPI drug discontinuation and renal function can recover back to normal following the introduction of systemic corticosteroid treatment. Any delay in treating this complication could result in definitive and irreversible renal injury.
免疫检查点抑制剂（ICPI）的最新进展使肿瘤患者的治疗效果得到了显著改善。细胞毒性 T 淋巴细胞抗原 4（CTLA-4）和程序性死亡蛋白 1（PD-1）是两种重要的免疫检查点受体。伊匹单抗和曲美木单抗（抗 CTLA-4 阻断抗体）以及派姆单抗和纳武单抗（针对 PD-1 受体的抗体）已经被美国食品和药物管理局批准用于多种恶性肿瘤。目前已经确定了两种不同形式的 ICPI 诱导的肾损伤，包括急性（肉芽肿性）肾小管间质性肾炎和免疫复合物肾小球肾炎。在停用 ICPI 药物后，观察到的急性肾损伤可以逆转，并且在全身性皮质类固醇治疗后肾功能可以恢复正常。如果对这种并发症的治疗出现延迟，可能会导致终末期和不可逆的肾损伤。
