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Diabetes Care：免疫检查点抑制剂相关糖尿病临床特征

2020-10-14 MedSci原创 MedSci原创

糖尿病临床特征免疫检查点抑制剂
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ICI-DM发病突然，似乎不可逆，以胰腺萎缩为特征，与PD-1抑制相比，在PD-L1阻断和GAD65自身抗体阳性的患者中ICI-DM发病可能更早。

近日，糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章，研究人员旨在通过单中心病例系列确定免疫检查点抑制剂相关的糖尿病（ICI-DM）临床特征。

研究人员对18例接受抗程序性细胞死亡蛋白1（PD-1）/抗程序性细胞死亡蛋白配体1（PD-L1）治疗后新发ICI-DM的晚期腺癌患者进行了回顾性病例分析。

在18例患者中，9例患者伴有糖尿病酮症酸中毒（血糖中位数为27.92 mmol/L；就诊前血糖中位数为6.35 mmol/L）。在ICI-DM诊断时，C肽的中位数很低，并且在随访期间有所下降。ICI-DM发病之前接受抗PD-1/抗PD-L1治疗持续时间中位数为3.65个月（范围为0.56至12.23个月）。在GAD65自身抗体阳性和阴性的患者中，ICI-DM发作的时间中位数分别为1.4个月/3个ICI周期和6个月/10个周期。接受抗PD-L1或抗PD-1治疗后发生ICI-DM的时间中位数分别为2.5个月/3个ICI周期和4.8个月/8周期。影像学上可见明显的胰腺萎缩。

由此可见，ICI-DM发病突然，似乎不可逆，以胰腺萎缩为特征，与PD-1抑制相比，在PD-L1阻断和GAD65自身抗体阳性的患者中ICI-DM发病可能更早。
 
原始出处：
 
David J. Byun,et al.Immune Checkpoint Inhibitor–Associated Diabetes: A Single-Institution Experience.Diabetes care.2020.https://doi.org/10.2337/dc20-0609

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    2020-10-14 神盾医疗局局长Jack

    #胰腺#PD1作用有待分析

    1

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    2021-02-08 ms5439512287675881

    #BET#

    0

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    2021-05-01 木头人513

    #Diabetes#

    0

  4. 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    2021-04-25 智者为医08

    #DIA#

    0

  5. 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    2021-03-14 yeye5224612

    #临床特征#

    0

  6. 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    2021-08-23 jklm09

    #抑制剂#

    0

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authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Oct 31 16:16:29 CST 2020, time=2020-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340543, encodeId=577113405434f, content=<a href='/topic/show?id=dd1a29055c8' target=_blank style='color:#2F92EE;'>#免疫检查点#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29055, encryptionId=dd1a29055c8, topicName=免疫检查点)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKUdkK5dVTue7YQDvwqM1ugOuEpDZEzvXhoGClFiavehcrNAYDuPbks3MkKLPpyAEicgic80KguxwicYQ/132, createdBy=ec952500165, createdName=ms5187542471278033, createdTime=Fri Oct 16 10:22:57 CST 2020, time=2020-10-16, status=1, ipAttribution=), 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    2020-10-31 lovetcm

    #免疫检查点抑制剂#与#糖尿病#

    0

  8. 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    2020-10-16 ms5187542471278033

    #免疫检查点#

    0

  9. 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    2020-10-14 珍行

    学习

    0

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    2020-10-14 misszhang

    谢谢MedSci提供最新的资讯

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