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免疫检查点抑制剂引起的内分泌功能障碍的临床特征、管理和潜在生物标志物。

Clinical Characteristics, Management, and Potential Biomarkers of Endocrine Dysfunction Induced by Immune Checkpoint Inhibitors.

机构信息

Department of Endocrinology and Diabetes, Nagoya University Hospital, Nagoya, Japan.

Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Endocrinol Metab (Seoul). 2021 Apr;36(2):312-321. doi: 10.3803/EnM.2021.1007. Epub 2021 Apr 27.

Abstract

Immune-related adverse events (irAEs) affecting the endocrine glands are among the most frequent irAEs induced by immune checkpoint inhibitors (ICIs) and include hypopituitarism, primary adrenal insufficiency, thyrotoxicosis, hypothyroidism, hypoparathyroidism, and type 1 diabetes mellitus. Since the incidence and clinical features of endocrine irAEs vary according to the ICI used, it is important to understand the characteristics of these irAEs and to manage each one appropriately. Since some endocrine irAEs, including adrenal crisis and diabetic ketoacidosis, are potentially life-threatening, predicting the risk of endocrine irAEs before their onset is critical. Several autoantibodies have been detected in patients who develop endocrine irAEs, among which anti-thyroid antibodies may be predictive biomarkers of thyroid dysfunction. In this review, we describe the clinical features of each endocrine irAE induced by ICIs and discuss their potential biomarkers, including autoantibodies.

摘要

免疫相关不良事件(irAEs)影响内分泌腺体是免疫检查点抑制剂(ICIs)引起的最常见的 irAEs 之一,包括垂体功能减退症、原发性肾上腺功能不全、甲状腺毒症、甲状腺功能减退症、甲状旁腺功能减退症和 1 型糖尿病。由于内分泌 irAEs 的发生率和临床特征根据所使用的 ICI 而有所不同,因此了解这些 irAEs 的特征并对其进行适当的管理非常重要。由于一些内分泌 irAEs,包括肾上腺危象和糖尿病酮症酸中毒,可能危及生命,因此在其发生之前预测内分泌 irAEs 的风险至关重要。在发生内分泌 irAEs 的患者中已经检测到几种自身抗体,其中抗甲状腺抗体可能是甲状腺功能障碍的预测性生物标志物。在这篇综述中,我们描述了由 ICIs 引起的每种内分泌 irAE 的临床特征,并讨论了它们的潜在生物标志物,包括自身抗体。

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