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Advances in molecular mechanisms of immune checkpoint inhibitor-associated myocarditis
Received:August 04, 2021  Revised:January 10, 2022  Click here to download the full text
Citation of this paper:CHEN Yi-fan,CHENG Lei-lei,GE Jun-bo.Advances in molecular mechanisms of immune checkpoint inhibitor-associated myocarditis[J].Chinese Journal of Clinical Medicine,2022,29(2):260-266
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Author NameAffiliationE-mail
CHEN Yi-fan Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China  
CHENG Lei-lei Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai 200032, China  
GE Jun-bo Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China jbge@zs-hospital.sh.cn 
Abstract:Immune checkpoint inhibitors (ICIs) are regarded as the most widely used immunotherapy for malignancies, which mainly includes inhibitors of cytotoxic T lymphocyte associated antigen-4 (CTLA-4), programmed death protein-1/ligand-1 (PD-1/PD-L1) and lymphocyte activation gene-3 (LAG-3). One of the most fatal immune-related adverse events (irAE) resulted from ICIs is immune checkpoint inhibitor-associated myocarditis (ICIAM). The incidence of ICIAM in combination therapy is much higher than that of monotherapy. The molecular mechanisms of ICIAM mainly include immune checkpoints as neoantigens, heterotopic recognition of tumor homologous antigens, blocking the cardioprotective effect of immune checkpoints, generation of autoantibodies or inflammatory cytokines and abnormal regulation of microbial. There are several pharmacological and nonpharmacological regiments for the treatment of ICIAM. Multi-disciplinary efforts are still needed to explore the molecular mechanisms of ICIAM and to improve the treatment managements.
keywords:immune checkpoint inhibitors  immune checkpoint inhibitor-associated myocarditis  molecular mechanisms  heterotopic recognition  autoantibodies  inflammatory cytokines
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