Association of Acute Interstitial Nephritis With Programmed Cell Death 1 Inhibitor Therapy in Lung Cancer Patients
Association of Acute Interstitial Nephritis With Programmed Cell Death 1 Inhibitor Therapy in Lung Cancer Patients
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DOI：
10.1053/j.ajkd.2016.02.057
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发表时间：
2016-08-01
影响因子：
13.2
通讯作者：
Gettinger, Scott
中科院分区：
文献类型：
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作者：
Shirali, Anushree C.;Perazella, Mark A.;Gettinger, Scott
靶向程序性死亡1 （PD-1）信号通路的免疫检查点抑制剂最近被批准用于晚期预处理的非小细胞肺癌和黑色素瘤。临床试验数据表明，这些药物可能对肾脏有不良影响，但这些影响尚未得到很好的描述。我们报告了6例接受抗pd -1抗体治疗的肺癌患者急性肾损伤，每个病例在肾活检上都显示急性间质性肾炎（AIN）的证据。所有患者还接受了与AIN相关的其他药物（质子泵抑制剂和非甾体抗炎药）治疗，但在大多数情况下，这些药物的使用早于PD-1抑制剂治疗。在我们的患者中，AIN与这些药物的关联提高了PD-1抑制剂治疗可能释放t细胞免疫抑制的可能性，这种抑制通常允许肾脏耐受已知与AIN相关的药物。(C) 2016年由国家肾脏基金会，Inc。
Immune checkpoint inhibitors that target the programmed death 1 (PD-1) signaling pathway have recently been approved for use in advanced pretreated non-small cell lung cancer and melanoma. Clinical trial data suggest that these drugs may have adverse effects on the kidney, but these effects have not been well described. We present 6 cases of acute kidney injury in patients with lung cancer who received anti-PD-1 antibodies, with each case displaying evidence of acute interstitial nephritis (AIN) on kidney biopsy. All patients were also treated with other drugs (proton pump inhibitors and nonsteroidal anti-inflammatory drugs) linked to AIN, but in most cases, use of these drugs long preceded PD-1 inhibitor therapy. The association of AIN with these drugs in our patients raises the possibility that PD-1 inhibitor therapy may release suppression of T-cell immunity that normally permits renal tolerance of drugs known to be associated with AIN. (C) 2016 by the National Kidney Foundation, Inc.