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综述

肿瘤治疗中免疫检查点抑制剂相关的感染并发症

  • 王琦琦 ,
  • 李若瑜 ,
  • 刘伟
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  • 北京大学第一医院皮肤性病科,国家皮肤与免疫疾病临床医学研究中心,北京大学真菌和真菌病研究中心,北京市皮肤病分子诊断重点实验室,北京 100034

收稿日期: 2020-06-19

  网络出版日期: 2021-02-25

基金资助

国家自然科学基金(81671990、81861148028、81971912),科技部“艾滋病和肝炎等传染病防治重大专项”(2018ZX10712-001),科技部“创新药物研发重大专项”(2017ZX09304028009)

Infectious complications associated with the use of immune checkpoint inhibitors in oncology

  • WANG Qiqi ,
  • LI Ruoyu ,
  • LIU Wei
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  • Department of Dermatology and Venereology, Peking University First Hospital; National Clinical Research Center for Skin and Immune Diseases; Research Center for Medical Mycology, Peking University; Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing 100034, China

Received date: 2020-06-19

  Online published: 2021-02-25

Supported by

 

摘要

近年来,免疫检查点抑制剂(immune checkpoint inhibitors, ICI)作为肿瘤免疫治疗的重要方法之一受到了广泛关注。针对细胞毒性T淋巴细胞抗原4、程序性死亡受体1和程序性死亡配体1的ICI,其临床应用为黑色素瘤和其他肿瘤的治疗带来了希望。目前没有证据表明ICI会直接增加感染的风险,但因免疫功能上调所致免疫相关不良事件的患者进行免疫抑制治疗时机会性感染的风险可能会增加。另外在无免疫相关不良事件发生或未使用免疫抑制剂治疗的患者中也会出现潜伏感染的激活,因此ICI相关感染应该受到重视。本文针对ICI用于肿瘤治疗时出现感染性疾病的现象、可能机制及相关的预防和治疗策略进行了综述。

本文引用格式

王琦琦 , 李若瑜 , 刘伟 . 肿瘤治疗中免疫检查点抑制剂相关的感染并发症[J]. 微生物与感染, 2021 , 16(1) : 50 -56 . DOI: 10.3969/j.issn.1673-6184.2021.01.007

Abstract

In recent years, the use of immune checkpoint inhibitors (ICI) for tumor immunotherapy has received widespread attention. The development of checkpoint blocking antibodies against cytotoxic T lymphocyte antigen 4 (CTLA-4), programmed death receptor 1 (PD-1) and programmed death ligand 1 (PD-L1) has brought great hope for the treatment of melanoma and other tumors. There is no evidence that immune checkpoint inhibitors increase the risk of infection, but the upregulation of immune function leads to a series of immune-related adverse events (irAEs) which requires immunosuppressive therapy, and may lead to opportunistic infection. Cases of latent or chronic infection reactivation in the absence of irAEs have been reported. In this review, we focus on the phenomena, possible mechanisms and related prevention and treatment strategies of infectious complications associated with the use of immune checkpoint inhibitors in oncology.
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