免疫检查点抑制剂诱导的甲状腺功能障碍对心肌肌钙蛋白水平的影响。

IF 3.2 4区 医学 Q3 IMMUNOLOGY
Journal of Immunotherapy Pub Date : 2025-06-01 Epub Date: 2025-03-25 DOI:10.1097/CJI.0000000000000555
Yuma Shibutani, Atsushi Kawanobe, Shinya Suzuki, Takuro Imaoka, Kazuko Tajiri
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引用次数: 0

摘要

免疫检查点抑制剂(ICI)诱导的甲状腺功能障碍是最常见的内分泌免疫相关不良事件(irAE)。甲状腺激素对心血管系统有多种影响;然而,甲状腺irae对心血管疾病发展的影响尚不完全清楚。这项回顾性研究包括2017年1月至2022年7月期间在国家癌症中心东医院测量的94名接受ICIs并具有甲状腺功能和肌钙蛋白T水平(心脏损伤标志物)的患者。在94例患者中,36例(38%)患者在ICI治疗后随访期间肌钙蛋白水平升高。中位观察期为249天(四分位数间距124 ~ 502天)。在这36例患者中,有16例(44%)发现甲状腺irae[甲状腺功能减退(n=13)和甲状腺功能亢进(n=3)]相关。无论患者是否经历甲状腺irae,都没有出现明显的心血管疾病或死于心脏病。肌钙蛋白水平随着促甲状腺激素(TSH)水平的升高而升高。特别是,在ICI治疗后,TSH bb0 20 μIU/mL患者的肌钙蛋白水平显著升高(P =0.009)。总之,甲状腺irae可能会引起肌钙蛋白水平升高的心脏损伤,需要特别注意,特别是在TSH超过20 μIU/mL的甲状腺功能减退症病例中。因此,在ICI治疗后监测心脏指标和甲状腺功能是很重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of Immune Checkpoint Inhibitor-induced Thyroid Dysfunction on Cardiac Troponin Levels.

Immune checkpoint inhibitor (ICI)-induced thyroid dysfunction is the most frequent endocrine immune-related adverse event (irAE). Thyroid hormones have various effects on the cardiovascular system; however, the impact of thyroid irAEs on the development of cardiovascular diseases is not fully understood. This retrospective study included 94 patients who received ICIs and had thyroid function and troponin T levels, markers of cardiac damage, measured at the National Cancer Center Hospital East between January 2017 and July 2022. Of the 94 patients, 36 (38%) showed elevated troponin levels after ICI treatment during the follow-up period. The median observation period was 249 days (interquartile range, 124-502 d). Thyroid irAEs [hypothyroidism (n=13) and hyperthyroidism (n=3)] associations were found in 16 (44%) of these 36 patients. None of the patients developed overt cardiovascular disease or died of heart disease, regardless of whether they experienced thyroid irAEs. The troponin levels increased with increasing thyroid stimulating hormone (TSH) levels. In particular, troponin levels were significantly elevated in patients with TSH >20 μIU/mL after ICI treatment ( P =0.009). In conclusion, thyroid irAEs may cause cardiac damage indicated by elevated troponin levels, necessitating special attention, particularly in cases of hypothyroidism where TSH exceeds 20 μIU/mL. Therefore, it is important to monitor cardiac markers along with thyroid function after ICI treatment.

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来源期刊
Journal of Immunotherapy
Journal of Immunotherapy 医学-免疫学
CiteScore
6.90
自引率
0.00%
发文量
79
审稿时长
6-12 weeks
期刊介绍: Journal of Immunotherapy features rapid publication of articles on immunomodulators, lymphokines, antibodies, cells, and cell products in cancer biology and therapy. Laboratory and preclinical studies, as well as investigative clinical reports, are presented. The journal emphasizes basic mechanisms and methods for the rapid transfer of technology from the laboratory to the clinic. JIT contains full-length articles, review articles, and short communications.
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