免疫檢查點抑制劑導致腎臟免疫相關不良事件的診斷與治療

The Diagnosis and Treatment of Immune Check Point Inhibitor-Induced Renal Immune-Related Adverse Events

林靚鈞(Ching-Chun Lin) ； 黃絜歆(Chieh-Hsin Huang) ； 黃騰慶(Teng-Ching Huang) ； 張育誌(Yu-Tzu Chang)

《腎臟與透析》 35卷2期 (2023/06) Pp. 77-82

https://doi.org/10.6340/KD.202306_35(2).0005

摘要

免疫檢查點抑制劑的發明，改變了傳統的癌症療法。免疫檢查點抑制劑透過增強T細胞對癌細胞的辨認與攻擊，達到有效的抗癌效果。然而，免疫檢查點抑制劑也可能造成免疫相關不良事件。腎臟免疫相關不良事件相當罕見，以急性腎小管間質腎炎為主。一般的實驗室檢查特異性不足，確定診斷需要依賴腎臟切片，以類固醇治療的反應良好。本篇文章旨在介紹腎臟免疫相關不良事件的致病機轉、急性腎損傷的形式、診斷與治療方式。

關鍵字

免疫檢查點抑制劑 ； 免疫相關不良事件 ； 急性腎損傷 ； 急性腎小管間質腎炎

並列摘要

The introduction of immune checkpoint inhibitors alters the conventional way of anti-cancer treatment. The anti-cancer effect of immune checkpoint inhibitors is attributed to enhancing the recognition and eradication of tumor cells by T cells. However, immune checkpoint inhibitors could also cause immune-related adverse events (irAEs). IrAE with renal involvement is rare, and once occurs, it commonly manifests as acute tubulointerstitial nephritis. General laboratory studies have limited specificity for identifying renal irAE. To achieve definitive diagnosis, renal biopsy is crucial. Renal irAE has good therapeutic response to steroid treatment. In this article, we introduce the pathophysiology, the manifestation of acute kidney injury, diagnosis and treatment of renal irAE.

並列關鍵字

immune checkpoint inhibitors ； immune-related adverse events ； acute kidney injury ； acute tubulointerstitial nephritis