Type 1 diabetes induced by immune checkpoint inhibitors / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 2595-2598, 2020.
Article
in English
| WPRIM
| ID: wpr-877820
ABSTRACT
With the increasing use of immune checkpoint inhibitors (ICI) including anti-cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1) in cancers, ICI-induced type 1 diabetes has been reported throughout the world. In this review, we aim to summarize the characteristics of this disease and discuss the mechanism of it. As an immune-related adverse event, type 1 diabetes developed after the administration of anti-PD-1 or anti-PD-ligand 1 (PD-L1) in the combination with or without anti-CTLA-4. It usually presented with acute onset, and 62.1% of the reported cases had diabetic ketoacidosis. Only a third of them had positive autoantibodies associated with type 1 diabetes. Susceptible HLA genotypes might be associated. T-cell-stimulation by blocking of the interaction of PD-1 and PD-L1 in pancreatic β cells was the main mechanism involved in the pathology. Insulin was the only effective treatment of ICI-induced type 1 diabetes. In conclusions, ICI-induced type 1 diabetes is a potentially life-threating adverse event after the immunotherapy of cancers. Screening and early recognition is important. Further investigation of the mechanism may help to better understand the pathology of type 1 diabetes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Diabetes Mellitus, Type 1
/
CTLA-4 Antigen
/
Immune Checkpoint Inhibitors
/
Immunologic Factors
/
Immunotherapy
/
Neoplasms
Limits:
Humans
Language:
English
Journal:
Chinese Medical Journal
Year:
2020
Type:
Article
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