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Outline
Immune checkpoint inhibitors (ICIs) are the core of tumour immunotherapy, but they are prone to induce immune-associated adverse events (irAEs). ICIs-associated enterocolitis is the most common and important irAE in the gastrointestinal tract, accounting for 37% of the fatal irAEs, which seriously affects the treatment and prognosis of patients. The incidence varies by drug: 7.7%~15% for cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitors, 1%~2% for programmed death-ligand 1(PD-1/PD-L1) inhibitors single therapy, rising to 13.9%~40% for combination therapy. The time of onset is earlier for CTLA-4 inhibitors (1~3 months) and later for PD-1/PD-L1 inhibitors (3~6 months). Risk factors include high-dose ICIs, combination therapy, previous history of IBD, intestinal dysbiosis, NSAIDs use, and genetic polymorphisms. Clinical manifestations are centered on diarrhiea, which can lead to complications such as intestinal perforation. The diagnosis is multifactorial, with biomarkers such as fecal calproteatin being important. The treatment is graded, with biologics improving difficult-to-treat cases, and the majority of patients with enterocolitis have a better prognosis.
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| 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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