中国新药杂志

免疫检查点抑制剂致急性肾损伤的研究进展

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汪龙 ¹ , 金荣 ² , 韩一萱 ¹ , 汪娟 ³ , 朱玲娜 ¹

中国新药杂志 | 综述 2021,30(1): 38-42

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中国新药杂志 |综述 2021 , 30 (1) : 38 -42

免疫检查点抑制剂致急性肾损伤的研究进展

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汪龙¹, 金荣², 韩一萱¹, 汪娟³, 朱玲娜¹

作者信息

¹蚌埠市第三人民医院药学部，蚌埠　233099

²宁夏中医医院暨中医研究院药学部，银川　750021

³上海市杨浦区市东医院急诊科，上海　200438

作者简介:

汪龙，男，主管药师，硕士研究生，主要从事临床药学、肿瘤药学的研究。联系电话：（0552）2054696，E-mail：373441116@qq.com。

Research progress of immune checkpoint inhibitor-induced acute kidney injury

Long WANG¹, Rong JIN², Yi-xuan HAN¹, Juan WANG³, Ling-na ZHU¹

Affiliations

¹Department of Pharmacy, the Third People's Hospital of Bengbu, Bengbu 233099, China

²Department of Pharmacy, Ningxia Hospital of Traditional Chinese Medicine and Research Institute of Traditional Chinese Medicine, Yinchuan 750021, China

³Department of Emergency, East City Hospital of Shanghai Yangpu District, Shanghai 200438, China

出版时间: 2021-01-15

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摘要

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免疫检查点抑制剂（ICPi）是一种靶向作用于表达在T细胞表面的免疫抑制分子的单克隆抗体，其作为一种新兴的免疫治疗药物，已广泛用于治疗各种实体肿瘤和血液系统肿瘤。然而，ICPi也导致了一类新的自体免疫相关不良反应的发生，一般称之为免疫治疗相关不良反应（irAEs）。急性肾损伤（AKI）为ICPi常见的irAEs之一，本文就ICPi诱发AKI的临床表现、发生率、危险因素、发生机制及相关治疗等内容进行综述。ICPi致AKI的风险明显高于化疗药物，其发生的危险因素涉及ICPi药物种类和联用质子泵抑制剂（PPIs）。ICPi所致AKI最常见的临床表现为血清肌酐升高和脓尿，典型的组织病理学特征为急性肾小管间质性肾炎（ATIN）。在使用ICPi治疗期间应密切监测肾功能，以便早期发现及干预AKI，治疗以糖皮质激素治疗为主，必要时可加用免疫抑制类药物。本研究可为我国ICPi的临床安全应用提供参考，以期改善肿瘤患者预后，使其更大程度获益。

关键词

免疫检查点抑制剂 / 急性肾损伤 / 免疫治疗相关不良反应

Abstract

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Immune checkpoint inhibitors (ICPis), a kind of monoclonal antibodies that target inhibitory receptors expressed on T cells, represent an emerging class of immunotherapy used in treating solid organ and hematologic malignancies. Unfortunately, ICPis have also been associated with the emergence of a new subsets of autoimmune-like toxicities, known as immune-related adverse events (irAEs). Acute kidney injury (AKI) is one of the common irAEs. This paper reviews the clinical manifestations, incidence, risk factors, mechanisms and treatment of ICPi-induced AKI. The risk of ICPi-induced AKI is significantly higher than that induced by chemotherapeutic drugs, and the involved risk factors include the type of ICPi drug and the proton pump inhibitors (PPIs). The typical symptom of ICPi-induced AKI is increased serum levels of creatinine and pyuria. The typical histopathological features are acute tubulointerstitial nephritis (ATIN). During ICPi treatment, renal function should be closely monitored to detect and intervene AKI early. The main treatment is glucocorticoid therapy, and immunosuppressive drugs can be added when necessary. This study provides reference for the clinical safety application of ICPi in China with a view to improve the prognosis of cancer patients and make them more beneficial.

Key words

immune checkpoint inhibitors (ICPi) / acute kidney injury (AKI) / immune-related adverse effects (irAEs)

引用本文

汪龙, 金荣, 韩一萱, 汪娟, 朱玲娜. 免疫检查点抑制剂致急性肾损伤的研究进展. 中国新药杂志, 2021 , 30 (1) : 38 -42 .

Long WANG, Rong JIN, Yi-xuan HAN, Juan WANG, Ling-na ZHU. Research progress of immune checkpoint inhibitor-induced acute kidney injury[J]. Chinese Journal of New Drugs, 2021 , 30 (1) : 38 -42 .

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2021年第30卷第1期

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首发时间：2026-10-29
出版时间：2021-01-15

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录用日期：2019-12-20

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¹蚌埠市第三人民医院药学部，蚌埠　233099

²宁夏中医医院暨中医研究院药学部，银川　750021

³上海市杨浦区市东医院急诊科，上海　200438

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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