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免疫检查点抑制剂诱发的甲状腺炎及其潜在机制。

Immune checkpoint inhibitor-induced thyroiditis and its potential mechanisms.

作者信息

Mao Xueqian, Mao Chaoming, Liu Jiameng, Wang Xi, Mao Yufei

机构信息

Department of Nuclear Medicine, The Affiliated Hospital of Jiangsu University, Zhenjiang, China.

Department of Ultrasound Medicine, The Affiliated Hospital of Jiangsu University, Zhenjiang, China.

出版信息

Front Endocrinol (Lausanne). 2025 Jun 4;16:1584675. doi: 10.3389/fendo.2025.1584675. eCollection 2025.

Abstract

The expanding clinical utilization of immune checkpoint inhibitors (ICIs) in oncology has brought increasing attention to thyroid dysfunction as a prominent immune-related adverse event (irAE). Elucidating the pathophysiological mechanisms underlying ICI-induced thyroiditis represents a critical step toward developing evidence-based diagnostic protocols and targeted therapeutic interventions for cancer patients undergoing immunotherapy. This comprehensive review systematically examines current advances in understanding the etiopathogenesis of ICI-induced thyroiditis. First, we described pharmacological characterization of ICIs, then discussed multifactorial analysis of cellular and molecular contributors to thyroid autoimmunity following ICI administration and finally analyzed critical evaluation of emerging hypotheses regarding primary pathogenic drivers. Through this review, we aim to establish mechanistic connections between ICI pharmacodynamics and thyroid tissue immunopathology.

摘要

免疫检查点抑制剂(ICI)在肿瘤学领域的临床应用不断扩大,这使得甲状腺功能障碍作为一种突出的免疫相关不良事件(irAE)受到越来越多的关注。阐明ICI诱发甲状腺炎的病理生理机制,是为接受免疫治疗的癌症患者制定循证诊断方案和靶向治疗干预措施的关键一步。这篇综述系统地审视了目前在理解ICI诱发甲状腺炎病因学方面取得的进展。首先,我们描述了ICI的药理学特征,接着讨论了ICI给药后导致甲状腺自身免疫的细胞和分子因素的多因素分析,最后分析了对有关主要致病驱动因素的新假说的批判性评估。通过这篇综述,我们旨在建立ICI药效学与甲状腺组织免疫病理学之间的机制联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c93/12173899/4c6a29ae0ba2/fendo-16-1584675-g001.jpg

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