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首页> 外文期刊>Терапевтичесκий архив >Kidney injury associated with antitumor therapy: focus on the adverse events of modern immuno-oncological drugs
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Kidney injury associated with antitumor therapy: focus on the adverse events of modern immuno-oncological drugs

机译:与抗肿瘤治疗相关的肾损伤:专注于现代免疫肿瘤药物的不良事件

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摘要

Immune checkpoint inhibitors (ICIs), including cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) and programmed death protein 1 (PD-1) or its ligand (PD-L1), are a new generation of immuno-oncological drugs that to date have demonstrated efficacy in a number of malignancies. The mechanism of ICT inhibitors action consist in the potentiation of the immune response by eliminating the tumor cells inhibitory effect on the T-lymphocytes activation. However, excessive immune system activation can cause the development of a special class of immune-related adverse events (irAEs) involved a wide variety of organs and systems, including the kidneys. Despite the fact that immuno-mediated kidney injury caused by ICI therapy develops quite rarely, it can be serious and determine the patient's prognosis, which necessitates early diagnosis and timely start of treatment. In this regard, awareness of the manifestations of ICI-associated renal irAEs is particularly relevant not only for oncologists and for nephrologists, but for doctors of other specialties. In this review, we elucidated the main variants of immuno-mediated kidney injury caused by ICI therapy, discussed possible predictors and mechanisms of their development, and considers the general principles of diagnosis and management of patients according to the severity of irAEs.
机译:免疫检查点抑制剂(ICIs),包括细胞毒性T淋巴细胞相关抗原4(CTLA-4)和程序性死亡蛋白1(PD-1)或其配体(PD-L1),是新一代的免疫肿瘤药物,迄今已证明对许多恶性肿瘤有效。ICT抑制剂的作用机制在于通过消除肿瘤细胞对T淋巴细胞活化的抑制作用来增强免疫反应。然而,免疫系统过度激活可导致一类特殊的免疫相关不良事件(IRAE)的发生,涉及多种器官和系统,包括肾脏。尽管ICI治疗引起的免疫介导的肾损伤很少发生,但它可能很严重,并决定患者的预后,这需要早期诊断和及时开始治疗。在这方面,对ICI相关肾病毒表现的认识不仅对肿瘤学家和肾病学家,而且对其他专业的医生都特别重要。在这篇综述中,我们阐明了ICI治疗引起的免疫介导肾损伤的主要变体,讨论了其发展的可能预测因素和机制,并根据IRAE的严重程度考虑了患者诊断和治疗的一般原则。

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