Kim Youngho
Pacific Nephrology Associates, Tacoma, WA, USA.
Clin Kidney J. 2019 Jun 21;14(1):418-420. doi: 10.1093/ckj/sfz074. eCollection 2021 Jan.
Advances in monoclonal antibody technology have enabled the application of engineered antibodies to interfere with specific immune pathways. Checkpoint inhibitors have shown promising results in treating certain cancers by employing patients' own immune systems to attack cancer cells. Checkpoint inhibitors release the brake on the immune system and can cause immune-related diseases. Theoretically this could be disadvantageous in patients with autoimmune diseases. Here I describe a case of nephrotic syndrome relapse in a patient with a history of membranous nephropathy during programmed death-ligand 1 inhibitor therapy for lung cancer. It is postulated that enhancement of the immune system triggered the relapse of nephrotic syndrome by leading to an escape of immune tolerance and increased susceptibility.
单克隆抗体技术的进步使得工程抗体能够应用于干扰特定的免疫途径。检查点抑制剂通过利用患者自身的免疫系统攻击癌细胞，在治疗某些癌症方面已显示出有前景的结果。检查点抑制剂解除了免疫系统的刹车，可能导致免疫相关疾病。从理论上讲，这在自身免疫性疾病患者中可能是不利的。在此，我描述了一例肺癌患者在接受程序性死亡配体1抑制剂治疗期间，患有膜性肾病病史的肾病综合征复发的病例。据推测，免疫系统的增强通过导致免疫耐受的逃逸和易感性增加，引发了肾病综合征的复发。
