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免疫检查点抑制剂相关神经不良事件及其与抗神经元自身抗体相关性的系统评价。

A systematic review of immune checkpoint inhibitor-related neurological adverse events and association with anti-neuronal autoantibodies.

作者信息

Salim Ayesha, Tapia Rico G, Shaikh A, Brown M P

机构信息

Cancer Clinical Trials Unit, Royal Adelaide Hospital, Adelaide, South Australia.

School of Medicine, University of Adelaide, Adelaide, South Australia.

出版信息

Expert Opin Biol Ther. 2021 Sep;21(9):1237-1251. doi: 10.1080/14712598.2021.1897101. Epub 2021 Apr 16.

Abstract

: Immune checkpoint inhibitors (ICI) therapy has led to a paradigm shift in cancer drug development and in the clinical evaluation of approaches to combination cancer treatment. Dysregulation of the immune system by ICI therapy may also elicit autoimmune phenomena and consequently manifest clinically as immune-related adverse events (irAEs) including neurological irAEs. : The purpose of this review is to explore the role of autoantibodies in the diagnosis and prediction of neurological irAEs and to evaluate their pathogenicity. We searched Pubmed and Embase for neurological irAEs and associated autoantibodies and found 28 patients with central and peripheral neurological irAEs. Of these patients, up to 40% had encephalitis, 34.4% with myasthenia gravis and 22% of patients with peripheral neuropathy and Guillain-Barre Syndrome had autoantibodies. : Overall, our survey suggested a causal relationship between neurological irAEs and autoantibodies. Detection of autoantibodies may help to diagnose neurological irAEs and inform their clinical management.

摘要

免疫检查点抑制剂(ICI)疗法已在癌症药物研发以及癌症联合治疗方法的临床评估方面引发了范式转变。ICI疗法导致的免疫系统失调也可能引发自身免疫现象,并因此在临床上表现为免疫相关不良事件(irAE),包括神经系统irAE。:本综述的目的是探讨自身抗体在神经系统irAE诊断和预测中的作用,并评估其致病性。我们在PubMed和Embase上搜索了神经系统irAE及相关自身抗体,发现了28例中枢和外周神经系统irAE患者。在这些患者中,高达40%患有脑炎,34.4%患有重症肌无力,22%患有周围神经病变和吉兰-巴雷综合征的患者体内存在自身抗体。:总体而言,我们的调查表明神经系统irAE与自身抗体之间存在因果关系。自身抗体的检测可能有助于诊断神经系统irAE并为其临床管理提供依据。

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