Neurologic manifestations of autoimmunity with immune checkpoint inhibitors.

Q2 Medicine

Handbook of clinical neurology Pub Date : 2024-01-01 DOI:10.1016/B978-0-12-823912-4.00024-4

Jennifer A McCombe, Elia Sechi, Anastasia Zekeridou

引用次数: 0

Abstract

Immune checkpoint inhibitors (ICIs) are cancer immunotherapies that enhance the body's own immune system to treat cancer. ICI treatment, however, can cause immune-related adverse events (irAEs) that can affect any organ, resulting in significant morbidity and mortality. Neurologic irAEs (nirAEs) are rare and can affect the peripheral nervous system more commonly than the central nervous system. Treatment is dependent on the severity of the neurologic manifestations and often includs discontinuation of the ICI and initiation of steroid therapy as the first line; other treatments have also been used. NirAEs and cardiac irAEs have higher fatality rates underlying the importance of early recognition and appropriate management. This chapter reviews the clinical manifestations of neurologic immune-related adverse events associated with ICI treatment as well as diagnostic and therapeutic modalities.

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使用免疫检查点抑制剂后自身免疫的神经系统表现。

免疫检查点抑制剂（ICIs）是一种癌症免疫疗法，可增强人体自身的免疫系统来治疗癌症。然而，ICI 治疗可引起免疫相关不良事件（irAEs），这些不良事件可影响任何器官，导致严重的发病率和死亡率。神经系统不良事件（nirAEs）比较罕见，影响外周神经系统的情况比影响中枢神经系统更为常见。治疗方法取决于神经系统表现的严重程度，通常包括停用 ICI 和启动类固醇治疗作为一线治疗；也曾使用过其他治疗方法。NirAEs和心脏irAEs的致死率较高，这说明早期识别和适当治疗的重要性。本章回顾了与 ICI 治疗相关的神经系统免疫相关不良事件的临床表现以及诊断和治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Handbook of clinical neurology Medicine-Neurology (clinical)

CiteScore

4.10

自引率

0.00%

发文量

302

期刊介绍： The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.