Overview of the Cardiotoxicity Induced by PD-1/PD-L1 Immune Checkpoint Inhibitor in Critical Care
, Xiaojing Zou, Huaqing Shu, You Shang*, - DOI
- 10.2991/icres.k.210524.001How to use a DOI?
- Keywords
- Immune checkpoint inhibitor; PD-1; PD-L1; cardiotoxicity
- Abstract
The Programmed Cell Death 1 (PD-1)/Programmed Death Ligand 1 (PD-L1) Immune Checkpoint Inhibitors (ICIs), have become a hot spot in the field of cancer research and treatment, and bring new hope to patients with advanced tumors. But, in addition to enhancing the anti-tumor effect of T cells, PD-1/PD-L1 inhibitors can also abnormally enhance the immune response, leading to the imbalance of immune tolerance. So, the adverse reactions of multiple system damage, including cardiotoxicity, which are named as immune-related adverse events, emerged one after another. PD-1/PD-L1 inhibitors-related cardiotoxicity is rare but fatal T-cell-driven drug reaction, which includes myocarditis, pericardial disease, vasculitis, Takotsubo syndrome, etc. The incidence of cardiotoxicity is not over 1%, but with high mortality. In recent years, with the popularity of PD-1/PD-L1 ICIs, increasing patients have been admitted to critical care because of severe or fatal cardiotoxicity. At present, adverse cardiac events caused by cardiotoxicity is not systematically reviewed, Intensive care physicians know little about this, and its treatment experience is even less. This review focuses on current knowledge about severe adverse cardiac events caused by PD-1/PD-L1 inhibitors. This study aimed to improve the intensive care physician’s understanding and attention to cardiotoxicity induced by PD-1/PD-L1 inhibitors.
- Chinese Abstract
程序性细胞凋亡蛋白1（PD-1）/程序性细胞凋亡蛋白配体1（PD-L1）免疫检查点抑制剂（ICIs）已成为癌症研究和治疗领域的热点，为晚期肿瘤患者带来新希望。但是，PD-1/PD-L1抑制剂除了通过“激活”T细胞发挥抗肿瘤活性外，还会增强免疫异常反应，导致免疫耐受失衡。免疫相关不良事件包括心脏毒性在内的多系统损害的不良反应层出不穷。PD-1/PD-L1 抑制剂相关的心脏毒性是一种罕见但有致命威胁的的严重不良事件，包括心肌炎、心包疾病、血管炎、应激性心肌病等。心脏毒性的发生率不超过1%，但死亡率很高。近年来，随着 PD-1/PD-L1免疫检查点抑制剂的普及，越来越多的患者因严重或致命的心脏毒性而被送入重症监护室。目前，免疫相关性心脏毒性尚未有系统回顾，重症监护医师对此知之甚少，其治疗经验更是少之又少。本综述侧重基于对PD-1/PD-L1 抑制剂引起的严重心脏不良事件的现有认识，从而提高重症监护医师对 PD-1/PD-L1 抑制剂诱导的心脏毒性的理解和关注。
- Copyright
- © 2021 First Affiliated Hospital of Zhengzhou University. Publishing services by Atlantis Press International B.V.
- Open Access
- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
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TY - JOUR AU - Ruiting Li AU - Xiaojing Zou AU - Huaqing Shu AU - You Shang PY - 2021 DA - 2021/06/05 TI - Overview of the Cardiotoxicity Induced by PD-1/PD-L1 Immune Checkpoint Inhibitor in Critical Care JO - Intensive Care Research SP - 11 EP - 15 VL - 1 IS - 1-2 SN - 2666-9862 UR - https://doi.org/10.2991/icres.k.210524.001 DO - 10.2991/icres.k.210524.001 ID - Li2021 ER -