Advances in immune checkpoint inhibitors induced-cardiotoxicity

Frontiers in Immunology

Immunology

Sai-Ching Jim Yeung¹  Jiao Wu²  Xiang Li²  Wenying Peng²  Runxiang Yang² 

[1] Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, TX, United States;Department of the Second Medical Oncology, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China;

关键词: cardiotoxicity;    immune checkpoint inhibitors;    immune-related adverse events;    Myocarditis;    Pericarditis;    Vasculitis;   

DOI  :  10.3389/fimmu.2023.1130438

 received in 2022-12-23, accepted in 2023-02-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

Immune checkpoint inhibitors (ICIs) are approved as the first-line drug for treating many cancers and has shown significant survival benefits; however, it also causes immune-related adverse events (irAEs) while activating the immune system, involving multiple organs. Among them, cardiovascular immune-related adverse events (CV-irAE) are rare, but common causes of death in ICIs treated cancer patients, which manifest as myocardial, pericardial, vascular and other cardiovascular toxicities. Therefore, it is important that irAEs, especially CV-irAE should be carefully recognized and monitored during the whole ICIs treatment because early detection and treatment of CV-irAE can significantly reduce the mortality of such patients. Consequently, it is urgent to fully understand the mechanism and management strategies of CV-irAE. The effects of ICIs are multifaceted and the exact mechanism of CV-irAE is still elusive. Generally, T cells identify tumor cell antigens as well as antigen in cardiomyocytes that are the same as or homologous to those on tumor cells, thus causing myocardial damage. In addition, ICIs promote formation of cardiac troponin I (cTnI) that induces cardiac dysfunction and myocardial dilatation; moreover, ICIs also increase the production of cytokines, which promote infiltration of inflammation-linked molecules into off-target tissues. Currently, the management and treatment of cardiovascular toxicity are largely dependent on glucocorticoids, more strategies for prevention and treatment of CV-irAE, such as predictive markers are being explored. This review discusses risk factors, potential pathophysiological mechanisms, clinical manifestations, and management and treatment of CV-irAE, guiding the development of more effective prevention, treatment and management strategies in the future.

【 授权许可】

Unknown   
Copyright © 2023 Li, Peng, Wu, Yeung and Yang