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免疫检查点抑制疗法中的心脏并发症

Cardiac Complications in Immune Checkpoint Inhibition Therapy.

作者信息

Tajiri Kazuko, Ieda Masaki

机构信息

Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

出版信息

Front Cardiovasc Med. 2019 Jan 23;6:3. doi: 10.3389/fcvm.2019.00003. eCollection 2019.

Abstract

Immune checkpoint inhibitors (ICIs) have changed the treatment landscape of advanced cancers. Unfortunately, these agents can induce a wide spectrum of immune-related adverse events (irAEs) through activation of immune responses in non-target organs, including the heart. As the clinical use of ICI therapy increases rapidly, management of irAEs is becoming extremely important. The most commonly presented cardiac irAE is myocarditis. Histopathologically, T-cell (with a predominance of CD8 cells) and macrophage infiltration in the myocardium is typically observed in ICI-associated myocarditis. Other presentations of cardiac irAEs include congestive heart failure, Takotsubo cardiomyopathy, pericardial disease, arrhythmias, and conduction disease. Although cardiac irAEs are relatively rare, they can be life-threatening. Hence, cardiologists and oncologists should be vigilant for these presentations.

摘要

免疫检查点抑制剂(ICIs)已经改变了晚期癌症的治疗格局。不幸的是,这些药物可通过激活非靶器官(包括心脏)中的免疫反应,诱发广泛的免疫相关不良事件(irAEs)。随着ICI疗法的临床应用迅速增加,irAEs的管理变得极为重要。最常见的心脏irAE是心肌炎。在组织病理学上,ICI相关心肌炎通常表现为心肌中T细胞(以CD8细胞为主)和巨噬细胞浸润。心脏irAEs的其他表现包括充血性心力衰竭、应激性心肌病、心包疾病、心律失常和传导疾病。虽然心脏irAEs相对罕见,但可能危及生命。因此,心脏病学家和肿瘤学家应对这些表现保持警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e48/6351438/7065422371bb/fcvm-06-00003-g0001.jpg

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