Cytotoxic T-Lymphocyte-associated antigen-4 blockage can induce autoimmune hypophysitis in patients with metastatic melanoma and renal cancer
Cytotoxic T-Lymphocyte-associated antigen-4 blockage can induce autoimmune hypophysitis in patients with metastatic melanoma and renal cancer
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DOI：
10.1097/01.cji.0000178913.41256.06
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发表时间：
2005-11-01
影响因子：
3.9
通讯作者：
Sherry, RM
中科院分区：
文献类型：
--
作者：
Blansfield, JA;Beck, KE;Sherry, RM
细胞毒性T淋巴细胞相关抗原4（CTLA-4）是由活化的T细胞和静息的CD 4（+）CD 25（+）T细胞表达的免疫调节分子。在晚期黑色素瘤患者中，我们的研究小组报告称，抗CTLA-4抗体的给药介导了13%患者的客观癌症消退。这项研究还确定了CTLA-4的阻断与III/IV级自身免疫表现相关，包括皮炎、小肠结肠炎、肝炎、葡萄膜炎和一例垂体炎。自该初始报告以来，已累积了7例抗CTLA-4抗体诱导的自身免疫性垂体炎患者。这8例患者的特征、临床病程、实验室检查值、影像学检查结果和治疗是本报告的重点。
Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) is an immunoregulatory molecule expressed by activated T cells and resting CD4(+)CD25(+) T cells. In patients with advanced melanoma, Our Group reported that administration of anti-CTLA-4 antibody mediated objective cancer regression in 13% of patients. This study also established that the blockade of CTLA-4 was associated with grade III/IV autoimmune manifestations that included dermatitis, enterocolitis, hepatitis, uveitis, and a single case of hypophysitis. Since this initial report, 7 additional patients with anti-CTLA-4 antibody-induced autoimmune hypophysitis have been accumulated. The characteristics, clinical course, laboratory values, radiographic findings, and treatment of these 8 patients are the focus of this report.