Działania niepożądane związane z układem immunologicznym w przebiegu terapii inhibitorami punktu kontrolnego

• Authors: Joanna Makowska , Anna Lewandowska-Polak

Title variants

EN

Immune-related adverse reactions as a result of therapy with check-point inhibitors

• Languages of publication: PL EN

Abstracts

PL

Inhibitory punktów kontrolnych układu immunologicznego (check-point inhibitors) stanowią dużą szansę dla pacjentów z chorobami nowotworowymi. Leki hamujące szlak PD1-PD1L oraz szlak CTLA4 znalazły zastosowanie w terapii licznych nowotworów złośliwych np. czerniaka czy raka płuc. Niestety ingerencja w przekazywanie sygnałów między komórkami prezentującymi antygen a limfocytami T może prowadzić do deregulacji układu immunologicznego, utraty tolerancji własnych antygenów i tkanek oraz pojawienia się objawów klinicznych chorób autoimmunologicznych. Działania niepożądane związane z układem immunologicznym (immune related adverse drug reaction, irAEs) dotyczą nawet 25% pacjentów leczonych, a u 6% pacjentów rozwijają się ciężkie reakcje. Najczęstsze reakcje niepożądane to objawy skórne, endokrynologiczne, objawy ze strony przewodu pokarmowego i oddechowego oraz ze strony nerek. W ostatnich latach pojawia się coraz więcej doniesień o pojawianiu się objawów reumatycznych takich jak zapalenie stawów, zespoły suchości, objawy polimialgii, wywołanych przez terapię. Celem poniższego artykułu jest przedstawienie obecnej wiedzy na temat patogenezy, diagnostyki i postępowania w przypadku wystąpienia działań niepożądanych związanych z układem immunologicznym w przebiegu terapii inhibitorami punktu kontrolnego ze szczególnym uwzględnieniem objawów reumatycznych.

EN

Check-point inhibitors are becoming a chance for patients with neoplasmatic disorders. The inhibitors of PD-1/PD1L and CTLA4 pathway are used in treatment of such neoplasmatic disorders as melanoma or lung cancer. Unfortunately interference with signaling between antigen presenting cells and T-Lymphocytes can lead to deregulation of immune system, loss of autotolerance and results in occurence of autoimmune diseases symptoms. Immune-related adverse drug reactions affects even 25% of treated patients and in 6% the observed reactions are severe. The most common clinical manifestation of these reactions include cutaneous symptoms, endocrine disturbances, complaints from gastrointestinal and respiratory systems and renal involvement as well. In the recent years it is reported that also “rheumatologic symptoms” like arthritis, polymyalgia or sicca symptoms are often observed in patients treated with check-point inhibitors. The aim of the article is to present the current knowledge on pathogenesis, clinical pattern, prevalence and treatment of immune-related adverse drug reactions evoked by check-point inhibitors.

Keywords

EN

inhibitory punktu kontrolnego; nadwrażliwość na leki; niepożądane reakcje polekowe; polimialgia; reumatoidalne zapalenie stawów; zespół Sjögrena

Discipline

• MEDICINE: MEDICINE

• Publisher: Oficyna Wydawnicza Mediton
• Journal: Alergia Astma Immunologia - przegląd kliniczny
• Year: 2018
• Volume: 23
• Issue: 1
• Pages: 2-6

Contributors

author

Joanna Makowska

• Klinika Reumatologii, Uniwersytet Medyczny w Łodzi

author

Anna Lewandowska-Polak

• Klinika Reumatologii, Uniwersytet Medyczny w Łodzi

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• Document Type: article