a Section of Nephrology, Department of Medicine , Yale University School of Medicine , New Haven , CT , USA.
b Section of Nephrology , Veterans Affairs Medical Center , West Haven , CT , USA.
Expert Rev Clin Pharmacol. 2019 Jun;12(6):513-521. doi: 10.1080/17512433.2019.1613888. Epub 2019 May 8.
: Advanced cancers that did not respond to chemotherapy were once a death sentence, but now there are newer therapies utilizing the patient's own immune system to fight cancer that are proving effective in chemotherapy-refractory malignancies. However, this success against cancer cells may be accompanied by immune-related adverse events that can affect the kidneys. : Using Medline and Scopus, we compiled all publications through February 2019 that pertained to immune checkpoint inhibitors (ICPIs) and chimeric antigen receptor T-cells (CAR T-cells). The focus of this review is the discussion of these new cancer therapies, with attention to the reported kidney-related adverse effects.. : Autoimmunity is repressed by molecular pathways that inhibit T-cell activation against selected antigens. These self-protective mechanisms have been appropriated by tumor cells as a means of evading immune detection and destruction. New immunotherapies such as immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy incite an aggressive immune response directed against tumor cells. This unrestrained activation of the immune system may result in kidney injury via multiple mechanisms.
: 对于那些对化疗没有反应的晚期癌症，曾经是死刑判决，但现在有利用患者自身免疫系统来对抗癌症的新疗法，这些疗法在化疗耐药性恶性肿瘤中已被证明有效。然而，这种对癌细胞的成功攻击可能伴随着免疫相关的不良反应，这些反应可能会影响肾脏。: 我们使用 Medline 和 Scopus，汇编了截至 2019 年 2 月所有与免疫检查点抑制剂（ICPIs）和嵌合抗原受体 T 细胞（CAR T 细胞）相关的出版物。本综述的重点是讨论这些新的癌症疗法，并关注已报道的与肾脏相关的不良反应。: 自身免疫受到抑制 T 细胞激活的分子途径抑制，这些途径针对特定抗原。这些自我保护机制被肿瘤细胞利用，作为逃避免疫检测和破坏的一种手段。免疫检查点抑制剂和嵌合抗原受体 T 细胞治疗等新的免疫疗法会引发针对肿瘤细胞的强烈免疫反应。免疫系统的这种不受控制的激活可能会通过多种机制导致肾脏损伤。
