Petrousis Grigorios, Szczegielniak Sylwester, Sabhan Haider, Elbe Peter, Bilican Gülden, Strid Hans, Bresso Francesca, Hedin Charlotte, Haas Stephan L
Centre for Digestive Health, Department of Gastroenterology, Dermatovenereology and Rheumatology, Karolinska University Hospital, Stockholm 17164, Sweden.
Department of Medicine Solna, Karolinska Institutet, Stockholm 17164, Sweden.
World J Gastrointest Endosc. 2025 Jul 16;17(7):107798. doi: 10.4253/wjge.v17.i7.107798.
Treatment with immune checkpoint inhibitors (ICIs) is an innovative therapy for managing certain types of malignancy and has the potential to improve overall patient survival significantly. The most widely used ICIs selectively target different receptors comprising programmed cell death-1 receptor, programmed cell death-ligand 1 receptor, and cytotoxic T lymphocyte antigen 4 receptor. The widespread utilization of ICIs over the past several years, however, is frequently accompanied by immune-related adverse events (irAEs) that substantially impact the patient's quality of life, particularly those affecting the digestive system, including both the upper and lower gastrointestinal tract. Based on a literature search covering databases such as PubMed, Web of Science, Embase, and the Cochrane Library, we present an insight into primary gastrointestinal irAEs, with a special focus on endoscopic manifestations. Additionally, we analyze data regarding the pathogenetic mechanisms, diagnostic approaches, histological characteristics, and proposed therapeutic interventions for managing irAEs involving the gastrointestinal tract.
免疫检查点抑制剂（ICI）治疗是一种用于治疗某些类型恶性肿瘤的创新疗法，有显著提高患者总体生存率的潜力。使用最广泛的ICI选择性靶向不同的受体，包括程序性细胞死亡蛋白1受体、程序性细胞死亡配体1受体和细胞毒性T淋巴细胞相关抗原4受体。然而，在过去几年中，ICI的广泛使用常常伴随着免疫相关不良事件（irAE），这些事件严重影响患者的生活质量，尤其是那些影响消化系统的事件，包括上、下胃肠道。基于对PubMed、Web of Science、Embase和Cochrane图书馆等数据库的文献检索，我们深入探讨了原发性胃肠道irAE，特别关注内镜表现。此外，我们分析了有关涉及胃肠道irAE的发病机制、诊断方法、组织学特征以及建议的治疗干预措施的数据。
