Immune checkpoint inhibitor diabetes mellitus: a novel form of autoimmune diabetes.,Clinical & Experimental Immunology

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Immune checkpoint inhibitor diabetes mellitus: a novel form of autoimmune diabetes.
Clinical & Experimental Immunology ( IF 3.4 ) Pub Date : 2020-02-28 , DOI: 10.1111/cei.13424
Z Quandt _{1,

2} , A Young ₁ , M Anderson _{1,

2}

Affiliation

Autoimmune diabetes mellitus is a rare but significant side effect of treatment with immune checkpoint inhibitors. Immune checkpoint inhibitor-induced diabetes mellitus (CPI-DM) is characterized by acute onset of dramatic hyperglycemia with severe insulin deficiency and occurrence following exposure to programmed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors rather than cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) inhibitors. As a growing number of patients undergo immunotherapy, further understanding of the characteristics of CPI-DM patients is needed for improved prognostic and diagnostic application in order to reduce overall morbidity for this already at-risk population. Additionally, understanding of the features and mechanisms of CPI-DM may contribute to understanding mechanisms of spontaneous type I diabetes mellitus (T1DM). Here, we summarize the clinical features of CPI-DM and interrogate the genetic and cellular mechanisms that may contribute to the disease, as well as the clinical challenges for predicting and treating these patients as increasing cancer immunotherapies reach clinical utility.

中文翻译：

免疫检查点抑制剂糖尿病：一种新型的自身免疫性糖尿病。

自身免疫性糖尿病是免疫检查点抑制剂治疗的一种罕见但显着的副作用。免疫检查点抑制剂诱发的糖尿病 (CPI-DM) 的特点是急性发作剧烈高血糖并伴有严重胰岛素缺乏，并在暴露于程序性细胞死亡-1/程序性细胞死亡配体-1 (PD-1/PD-L1) 后发生抑制剂而不是细胞毒性 T 淋巴细胞相关抗原 4 (CTLA-4) 抑制剂。随着越来越多的患者接受免疫治疗，需要进一步了解 CPI-DM 患者的特征，以改善预后和诊断应用，从而降低这一高危人群的总体发病率。此外，了解 CPI-DM 的特征和机制可能有助于了解自发性 I 型糖尿病 (T1DM) 的机制。在这里，我们总结了 CPI-DM 的临床特征，探讨了可能导致该疾病的遗传和细胞机制，以及随着越来越多的癌症免疫疗法达到临床应用，预测和治疗这些患者面临的临床挑战。

更新日期：2020-02-28

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