Pathogenesis, Pathological Characteristics and Individualized Therapy for Immune-related Adverse Effects

Overview

Journal Chin Med J Pulm Crit Care Med

Date 2024 Aug 22

PMID 39171279

Authors

Kang Miao

Li Zhang

Affiliations

Soon will be listed here.

Abstract

Immune checkpoint inhibitors (ICIs) are a class of antitumor medications that target immune checkpoints, which induce the activation of lymphocytes. These treatments effectively prolong the survival of patients with advanced tumors, especially lung cancer. However, in addition to tumor killing effects, ICIs may also cause an imbalance between immune tolerance and immunity. Over-activated lymphocytes may cause various types of damage to multiple organs throughout the body, called immune-related adverse events. In this review, we summarize the pathogenesis, pathological characteristics, biomarkers, and therapeutic agents for immune-related adverse events.

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References

Abu-Sbeih H, Ali F, Luo W, Qiao W, Raju G, Wang Y . Importance of endoscopic and histological evaluation in the management of immune checkpoint inhibitor-induced colitis. J Immunother Cancer. 2018; 6(1):95. PMC: 6156850. DOI: 10.1186/s40425-018-0411-1. View

Westdorp H, Sweep M, Gorris M, Hoentjen F, Boers-Sonderen M, van der Post R . Mechanisms of Immune Checkpoint Inhibitor-Mediated Colitis. Front Immunol. 2021; 12:768957. PMC: 8586074. DOI: 10.3389/fimmu.2021.768957. View

Carlos G, Anforth R, Chou S, Clements A, Fernandez-Penas P . A case of bullous pemphigoid in a patient with metastatic melanoma treated with pembrolizumab. Melanoma Res. 2015; 25(3):265-8. DOI: 10.1097/CMR.0000000000000155. View

Mahmood S, Fradley M, Cohen J, Nohria A, Reynolds K, Heinzerling L . Myocarditis in Patients Treated With Immune Checkpoint Inhibitors. J Am Coll Cardiol. 2018; 71(16):1755-1764. PMC: 6196725. DOI: 10.1016/j.jacc.2018.02.037. View

Salles G, Barrett M, Foa R, Maurer J, OBrien S, Valente N . Rituximab in B-Cell Hematologic Malignancies: A Review of 20 Years of Clinical Experience. Adv Ther. 2017; 34(10):2232-2273. PMC: 5656728. DOI: 10.1007/s12325-017-0612-x. View

Liu W, Fisher D . Epitope Spreading and the Efficacy of Immune Checkpoint Inhibition in Cancer. Int J Oncol Res. 2022; 4(1). PMC: 8889787. DOI: 10.23937/2643-4563/1710029. View

Ibraheim H, Perucha E, Powell N . Pathology of immune-mediated tissue lesions following treatment with immune checkpoint inhibitors. Rheumatology (Oxford). 2019; 58(Suppl 7):vii17-vii28. PMC: 6900915. DOI: 10.1093/rheumatology/kez465. View

Verschuren E, van den Eertwegh A, Wonders J, Slangen R, van Delft F, van Bodegraven A . Clinical, Endoscopic, and Histologic Characteristics of Ipilimumab-Associated Colitis. Clin Gastroenterol Hepatol. 2016; 14(6):836-842. DOI: 10.1016/j.cgh.2015.12.028. View

Hua C, Boussemart L, Mateus C, Routier E, Boutros C, Cazenave H . Association of Vitiligo With Tumor Response in Patients With Metastatic Melanoma Treated With Pembrolizumab. JAMA Dermatol. 2015; 152(1):45-51. DOI: 10.1001/jamadermatol.2015.2707. View

10.

Dai S, Jia R, Zhang X, Fang Q, Huang L . The PD-1/PD-Ls pathway and autoimmune diseases. Cell Immunol. 2014; 290(1):72-9. DOI: 10.1016/j.cellimm.2014.05.006. View

11.

Affolter T, Llewellyn H, Bartlett D, Zong Q, Xia S, Torti V . Inhibition of immune checkpoints PD-1, CTLA-4, and IDO1 coordinately induces immune-mediated liver injury in mice. PLoS One. 2019; 14(5):e0217276. PMC: 6528985. DOI: 10.1371/journal.pone.0217276. View

12.

Kunkl M, Amormino C, Caristi S, Tedeschi V, Fiorillo M, Levy R . Binding of Staphylococcal Enterotoxin B (SEB) to B7 Receptors Triggers TCR- and CD28-Mediated Inflammatory Signals in the Absence of MHC Class II Molecules. Front Immunol. 2021; 12:723689. PMC: 8418141. DOI: 10.3389/fimmu.2021.723689. View

13.

Stroud C, Hegde A, Cherry C, Naqash A, Sharma N, Addepalli S . Tocilizumab for the management of immune mediated adverse events secondary to PD-1 blockade. J Oncol Pharm Pract. 2017; 25(3):551-557. DOI: 10.1177/1078155217745144. View

14.

Cappelli L, Gutierrez A, Baer A, Albayda J, Manno R, Haque U . Inflammatory arthritis and sicca syndrome induced by nivolumab and ipilimumab. Ann Rheum Dis. 2016; 76(1):43-50. PMC: 5333990. DOI: 10.1136/annrheumdis-2016-209595. View

15.

Moslehi J, Lichtman A, Sharpe A, Galluzzi L, Kitsis R . Immune checkpoint inhibitor-associated myocarditis: manifestations and mechanisms. J Clin Invest. 2021; 131(5). PMC: 7919710. DOI: 10.1172/JCI145186. View

16.

Goldstein B, Gedmintas L, Todd D . Drug-associated polymyalgia rheumatica/giant cell arteritis occurring in two patients after treatment with ipilimumab, an antagonist of ctla-4. Arthritis Rheumatol. 2014; 66(3):768-9. DOI: 10.1002/art.38282. View

17.

Damsky W, Jilaveanu L, Turner N, Perry C, Zito C, Tomayko M . B cell depletion or absence does not impede anti-tumor activity of PD-1 inhibitors. J Immunother Cancer. 2019; 7(1):153. PMC: 6567557. DOI: 10.1186/s40425-019-0613-1. View

18.

Eun Y, Kim I, Sun J, Lee J, Cha H, Koh E . Risk factors for immune-related adverse events associated with anti-PD-1 pembrolizumab. Sci Rep. 2019; 9(1):14039. PMC: 6773778. DOI: 10.1038/s41598-019-50574-6. View

19.

Friedman C, Proverbs-Singh T, Postow M . Treatment of the Immune-Related Adverse Effects of Immune Checkpoint Inhibitors: A Review. JAMA Oncol. 2016; 2(10):1346-1353. DOI: 10.1001/jamaoncol.2016.1051. View

20.

Karamchandani D, Chetty R . Immune checkpoint inhibitor-induced gastrointestinal and hepatic injury: pathologists' perspective. J Clin Pathol. 2018; 71(8):665-671. DOI: 10.1136/jclinpath-2018-205143. View