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編者按：免疫檢查點(diǎn)抑制劑（ICI）作為腫瘤免疫治療的一種新方式而廣受關(guān)注, 但I(xiàn)CI通過調(diào)控免疫應(yīng)答殺傷腫瘤的同時(shí),，過度活化的免疫細(xì)胞也可能致機(jī)體多個(gè)系統(tǒng)產(chǎn)生自身免疫損傷,，即免疫相關(guān)不良反應(yīng),。1型糖尿病雖然是較為罕見的免疫相關(guān)不良反應(yīng),，但易發(fā)生危及生命的糖尿病酮癥酸中毒,，且多數(shù)需要終生依賴胰島素治療,。隨著臨床免疫檢查點(diǎn)抑制劑的廣泛臨床應(yīng)用,，免疫檢查點(diǎn)抑制劑相關(guān)1型糖尿病（ICI-T1DM）的發(fā)生勢(shì)必越來越多,，應(yīng)引起臨床重視,。在近期舉辦的2022中國(guó)醫(yī)師協(xié)會(huì)內(nèi)分泌代謝科醫(yī)師年會(huì)上，來自南京醫(yī)科大學(xué)第一附屬醫(yī)院的楊濤教授結(jié)合臨床病例分享了ICI-T1DM的診治進(jìn)展,。
從一個(gè)病例說起  內(nèi)分泌不良反應(yīng)是ICI最常見的不良反應(yīng)之一 ICI-T1DM的流行病學(xué) ICI-T1DM的遺傳學(xué)特征 ICI-T1DM的免疫學(xué)特征 ICI-T1DM的臨床特征 ICI-T1DM臨床管理 總結(jié)與展望 參考文獻(xiàn) 2,、谷志遠(yuǎn), 李薇, 楊濤, 劉曉云，陳家偉. 程序性死亡蛋白1抗體治療后暴發(fā)性1型糖尿病一例 [J] . 中華糖尿病雜志, 2020, 12(5) : 328-332. DOI: 10.3760/cma.j.cn115791-20191022-00382. 3,、施云, 沈敏, 顧愹, 楊濤. 免疫檢查點(diǎn)抑制劑相關(guān)1型糖尿病 [J] . 中華糖尿病雜志,2020,12 (12): 945-948. DOI: 10.3760/cma.j.cn115791-20200706-00418. 4,、Dougan M, Pietropaolo M. Time to dissect the autoimmune etiology of cancer antibody immunotherapy. The Journal of clinical investigation. 2020; 130(1): 51-61. DOI:10.1172/JCI131194. 5、Michot JM, Bigenwald C, Champiat S, et al. Immune-related adverse events with immune checkpoint blockade: a comprehensive review. Eur J Cancer. 2016; 54: 139-148. DOI:10.1016/j.ejca.2015.11.016. 6,、Barroso-Sousa R, Barry WT, Garrido-Castro AC, et al. Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Meta-analysis. JAMA Oncol. 2018; 4(2): 173-182. DOI:10.1001/jamaoncol.2017.3064. 7,、de Filette JMK, Pen JJ, Decoster L, et al. Immune checkpoint inhibitors and type 1 diabetes mellitus: a case report and systematic review. European journal of endocrinology / European Federation of Endocrine Societies. 2019; 181(3): 363-374. DOI:10.1530/EJE-19-0291. 8、Stamatouli AM, Quandt Z, Perdigoto AL, et al. Collateral Damage: Insulin-Dependent Diabetes Induced With Checkpoint Inhibitors. Diabetes. 2018; 67(8): 1471-1480. DOI:10.2337/dbi18-0002. 9,、Tsang VHM, McGrath RT, Clifton-Bligh RJ, et al. Checkpoint Inhibitor-Associated Autoimmune Diabetes Is Distinct From Type 1 Diabetes. The Journal of clinical endocrinology and metabolism. 2019; 104(11): 5499-5506. DOI:10.1210/jc.2019-00423. 10,、Kotwal A, Haddox C, Block M, et al. Immune checkpoint inhibitors: an emerging cause of insulin-dependent diabetes. BMJ Open Diabetes Res Care. 2019; 7(1): e000591. DOI:10.1136/bmjdrc-2018-000591. 11、Quandt Z, Young A, Anderson M. Immune checkpoint inhibitor diabetes mellitus: a novel form of autoimmune diabetes. Clinical and experimental immunology. 2020. DOI:10.1111/cei.13424. 12,、Wright JJ, Salem JE, Johnson DB, et al. Increased Reporting of Immune Checkpoint Inhibitor-Associated Diabetes. Diabetes care. 2018; 41(12): e150-e151. DOI:10.2337/dc18-1465. 13,、Clotman K, Janssens K, Specenier P, et al. Programmed Cell Death-1 Inhibitor-Induced Type 1 Diabetes Mellitus. The Journal of clinical endocrinology and metabolism. 2018; 103(9): 3144-3154. DOI:10.1210/jc.2018-00728. 14、Noble JA, Valdes AM. Genetics of the HLA region in the prediction of type 1 diabetes. Current diabetes reports. 2011; 11(6): 533-542. DOI:10.1007/s11892-011-0223-x. 15,、Gu Y, Zhang M, Chen H, et al. Discordant association of islet autoantibodies with high-risk HLA genes in Chinese type 1 diabetes. Diabetes/metabolism research and reviews. 2011; 27(8): 899-905. DOI:10.1002/dmrr.1270. 16,、Hughes J, Vudattu N, Sznol M, et al. Precipitation of autoimmune diabetes with anti-PD-1 immunotherapy. Diabetes care. 2015; 38(4): e55-57. DOI:10.2337/dc14-2349. 17、Yoneda S, Imagawa A, Hosokawa Y, et al. T-Lymphocyte Infiltration to Islets in the Pancreas of a Patient Who Developed Type 1 Diabetes After Administration of Immune Checkpoint Inhibitors. Diabetes care. 2019; 42(7): e116-e118. 18,、Marchand L, Reffet S, Dalle S, et al. Fulminant diabetes induced by PD-1 and PD-L1 inhibitors: what about glucose variability Acta diabetologica. 2019; 56(3): 377-378. DOI:10.1007/s00592-018-1262-4. 19,、Angelos K, Eka M, Wentin C, et al. Is immune checkpoint inhibitor-associated. diabetes the same as fulminant type 1 diabetes mellitus Clinical Medicine. 2020: 20(4): 417–23.DOI: 10.7861/clinmed.2020-0054. 20、Gunjur A, Klein O, Kee D, et al. Anti-programmed cell death protein 1 (anti-PD1) immunotherapy induced autoimmune polyendocrine syndrome type II (APS-2): a case report and review of the literature. J Immunother Cancer. 2019; 7(1): 241. 21,、Shi Y, Shen M, Zheng XQ, et al. ICPis-Induced Autoimmune Polyendocrine Syndrome Type 2: A Review of the Literature and a Protocol for Optimal Management. J Clin Endocrinol Metab.2020.Sep 9;dgaa553. 22,、Puzanov I, Diab A, Abdallah K, et al. Managing toxicities associated with immune checkpoint inhibitors: consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group. J Immunother Cancer. 2017; 5(1): 95. 23,、Castinetti F, Albarel F, Archambeaud F, et al. French Endocrine Society Guidance on endocrine side effects of immunotherapy. 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（來源：《國(guó)際糖尿病》編輯部） |
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