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논문 기본 정보

자료유형
학술저널
저자정보
Juwhan Choi (Korea University College of Medicine) Sung Yong Lee (Korea University College of Medicine)
저널정보
대한면역학회 Immune Network Immune Network Vol.20 No.1
발행연도
2020.2
수록면
120 - 140 (21page)

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초록· 키워드

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Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.

목차

ABSTRACT
INTRODUCTION
MECHANISM OF IRAES
ABDOMEN
ENDOCRINE ORGANS
HEMATOLOGIC COMPLICATIONS
JOINT AND SKIN
NERVOUS SYSTEM
OCULAR SYSTEM
THORAX
CONCLUSION
REFERENCES

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