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The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma

Treatment with immune checkpoint inhibitors (ICIs) has improved the prognosis of patients with a number of types of cancer, but the frequent development of immune-related adverse effects (irAEs) can worsen the outcome. The most common irAEs involve the gastrointestinal, cutaneous, and endocrine syst...

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Autores principales: Marco, Tucci, Anna, Passarelli, Annalisa, Todisco, Francesco, Mannavola, Stefania, Stucci Luigia, Stella, D’Oronzo, Michele, Rossini, Marco, Taurisano, Loreto, Gesualdo, Franco, Silvestris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759704/
https://www.ncbi.nlm.nih.gov/pubmed/31579108
http://dx.doi.org/10.1177/1758835919875549
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author Marco, Tucci
Anna, Passarelli
Annalisa, Todisco
Francesco, Mannavola
Stefania, Stucci Luigia
Stella, D’Oronzo
Michele, Rossini
Marco, Taurisano
Loreto, Gesualdo
Franco, Silvestris
author_facet Marco, Tucci
Anna, Passarelli
Annalisa, Todisco
Francesco, Mannavola
Stefania, Stucci Luigia
Stella, D’Oronzo
Michele, Rossini
Marco, Taurisano
Loreto, Gesualdo
Franco, Silvestris
author_sort Marco, Tucci
collection PubMed
description Treatment with immune checkpoint inhibitors (ICIs) has improved the prognosis of patients with a number of types of cancer, but the frequent development of immune-related adverse effects (irAEs) can worsen the outcome. The most common irAEs involve the gastrointestinal, cutaneous, and endocrine systems, but nephrotoxicity, resulting from damage to the tubule-interstitial compartment, may occur in some patients. The early phases of acute interstitial nephritis (AIN) are characterized by systemic symptoms that indicate a poor clinical state as well as a mild deterioration of renal function. Tubular injury is due to a direct effect mediated by cytotoxic CD8(+) T cells, which sustain the local production of pro-inflammatory cytokines that progressively impair renal function. The treatment of AIN is mainly based on high-dose steroids, which in most instances leads to the recovery of renal function. However, the premature discontinuation of ICI therapy may prevent the impact of treatment on the clinical progression of the malignancy. Adequately addressing irAEs requires a standardized therapy that is based on the results of large clinical trials.
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spelling pubmed-67597042019-10-02 The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma Marco, Tucci Anna, Passarelli Annalisa, Todisco Francesco, Mannavola Stefania, Stucci Luigia Stella, D’Oronzo Michele, Rossini Marco, Taurisano Loreto, Gesualdo Franco, Silvestris Ther Adv Med Oncol Review Treatment with immune checkpoint inhibitors (ICIs) has improved the prognosis of patients with a number of types of cancer, but the frequent development of immune-related adverse effects (irAEs) can worsen the outcome. The most common irAEs involve the gastrointestinal, cutaneous, and endocrine systems, but nephrotoxicity, resulting from damage to the tubule-interstitial compartment, may occur in some patients. The early phases of acute interstitial nephritis (AIN) are characterized by systemic symptoms that indicate a poor clinical state as well as a mild deterioration of renal function. Tubular injury is due to a direct effect mediated by cytotoxic CD8(+) T cells, which sustain the local production of pro-inflammatory cytokines that progressively impair renal function. The treatment of AIN is mainly based on high-dose steroids, which in most instances leads to the recovery of renal function. However, the premature discontinuation of ICI therapy may prevent the impact of treatment on the clinical progression of the malignancy. Adequately addressing irAEs requires a standardized therapy that is based on the results of large clinical trials. SAGE Publications 2019-09-24 /pmc/articles/PMC6759704/ /pubmed/31579108 http://dx.doi.org/10.1177/1758835919875549 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Marco, Tucci
Anna, Passarelli
Annalisa, Todisco
Francesco, Mannavola
Stefania, Stucci Luigia
Stella, D’Oronzo
Michele, Rossini
Marco, Taurisano
Loreto, Gesualdo
Franco, Silvestris
The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
title The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
title_full The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
title_fullStr The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
title_full_unstemmed The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
title_short The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
title_sort mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759704/
https://www.ncbi.nlm.nih.gov/pubmed/31579108
http://dx.doi.org/10.1177/1758835919875549
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