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Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives

In recent years, cancer immunotherapy has made remarkable achievements. Immune checkpoint inhibitors (ICIs) have been used successfully in several types of cancer in the past decade. However, expanded indication and increased use of Immune checkpoint inhibitors have resulted in increased reports of...

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Autores principales: Liu, Zherui, Zhu, Yun, Xie, Huan, Zou, Zhengsheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868416/
https://www.ncbi.nlm.nih.gov/pubmed/36699050
http://dx.doi.org/10.3389/fphar.2022.1077468
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author Liu, Zherui
Zhu, Yun
Xie, Huan
Zou, Zhengsheng
author_facet Liu, Zherui
Zhu, Yun
Xie, Huan
Zou, Zhengsheng
author_sort Liu, Zherui
collection PubMed
description In recent years, cancer immunotherapy has made remarkable achievements. Immune checkpoint inhibitors (ICIs) have been used successfully in several types of cancer in the past decade. However, expanded indication and increased use of Immune checkpoint inhibitors have resulted in increased reports of toxicity called immune-related adverse events (irAEs). Due to the unique immunological characteristics of the liver, a hepatic immune-related adverse events has also been reported, which is usually termed Immune-mediated hepatitis (IMH). So far, it is generally considered that the mechanism of IMH induced by Immune checkpoint inhibitors is mainly the overactivation of T cells. It has been reported that the incidence of IMH ranges from 1% to 15%. Because of the lack of specific markers, a diagnosis of exclusion of IMH is critical. Although most IMH is mild and recoverable, several death cases have been reported, which has been increasingly concerned. This review summarizes the current understanding of the pathophysiology, epidemiology, diagnosis, management and prognosis of IMH caused by Immune checkpoint inhibitors. It also discusses the controversial issues in IMH, such as the role of liver biopsy, grading criteria, risk factors, rational treatment strategies with steroids, and the timing of Immune checkpoint inhibitors rechallenging, which may provide helpful information for IMH in future clinical practice.
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spelling pubmed-98684162023-01-24 Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives Liu, Zherui Zhu, Yun Xie, Huan Zou, Zhengsheng Front Pharmacol Pharmacology In recent years, cancer immunotherapy has made remarkable achievements. Immune checkpoint inhibitors (ICIs) have been used successfully in several types of cancer in the past decade. However, expanded indication and increased use of Immune checkpoint inhibitors have resulted in increased reports of toxicity called immune-related adverse events (irAEs). Due to the unique immunological characteristics of the liver, a hepatic immune-related adverse events has also been reported, which is usually termed Immune-mediated hepatitis (IMH). So far, it is generally considered that the mechanism of IMH induced by Immune checkpoint inhibitors is mainly the overactivation of T cells. It has been reported that the incidence of IMH ranges from 1% to 15%. Because of the lack of specific markers, a diagnosis of exclusion of IMH is critical. Although most IMH is mild and recoverable, several death cases have been reported, which has been increasingly concerned. This review summarizes the current understanding of the pathophysiology, epidemiology, diagnosis, management and prognosis of IMH caused by Immune checkpoint inhibitors. It also discusses the controversial issues in IMH, such as the role of liver biopsy, grading criteria, risk factors, rational treatment strategies with steroids, and the timing of Immune checkpoint inhibitors rechallenging, which may provide helpful information for IMH in future clinical practice. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9868416/ /pubmed/36699050 http://dx.doi.org/10.3389/fphar.2022.1077468 Text en Copyright © 2023 Liu, Zhu, Xie and Zou. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Liu, Zherui
Zhu, Yun
Xie, Huan
Zou, Zhengsheng
Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives
title Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives
title_full Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives
title_fullStr Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives
title_full_unstemmed Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives
title_short Immune-mediated hepatitis induced by immune checkpoint inhibitors: Current updates and future perspectives
title_sort immune-mediated hepatitis induced by immune checkpoint inhibitors: current updates and future perspectives
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868416/
https://www.ncbi.nlm.nih.gov/pubmed/36699050
http://dx.doi.org/10.3389/fphar.2022.1077468
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AT zouzhengsheng immunemediatedhepatitisinducedbyimmunecheckpointinhibitorscurrentupdatesandfutureperspectives