A Concerted Vision to Advance the Knowledge of Diabetes Mellitus Related to Immune Checkpoint Inhibitors.
Int J Mol Sci
; 24(8)2023 Apr 21.
Article
in En
| MEDLINE
| ID: mdl-37108792
ABSTRACT
The rubric of immune-related (ir) diabetes mellitus (DM) (irDM) encompasses various hyperglycemic disorders related to immune checkpoint inhibitors (ICPis). Beyond sharing similarities with conventional DM, irDM is a distinct, yet important, entity. The present narrative review provides a comprehensive overview of the literature regarding irDM published in major databases from January 2018 until January 2023. Initially considered rare, irDM is increasingly being reported. To advance the knowledge of irDM, the present review suggests a concerted vision comprising two intertwined aspects a scientific-centered and a patient-centered view. The scientific-centered aspect addresses the pathophysiology of irDM, integrating (i) ICPi-induced pancreatic islet autoimmunity in genetically predisposed patients; (ii) altered gut microbiome; (iii) involvement of exocrine pancreas; (iv) immune-related acquired generalized lipodystrophy. The patient-centered aspect is both nurtured by and nurturing the four pillars of the scientific-centered aspect awareness, diagnosis, treatment, and monitoring of irDM. The path forward is a multidisciplinary initiative towards (i) improved characterization of the epidemiological, clinical, and immunological profile of irDM; (ii) standardization of reporting, management, and surveillance protocols for irDM leveraging global registries; (iii) patient stratification according to personalized risk for irDM; (iv) new treatments for irDM; and (v) uncoupling ICPi efficacy from immunotoxicity.
Key words
anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4) antibodies; anti-programmed cell death (anti-PD-1) antibodies; anti-programmed cell death ligand 1 (anti-PD-L1) antibodies; autoimmunity; diabetic ketoacidosis; immune checkpoint inhibitors; immune-related adverse events; immune-related diabetes mellitus; immunotoxicity; pancreatic islet autoantibodies
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Islets of Langerhans
/
Pancreas, Exocrine
/
Diabetes Mellitus
Type of study:
Guideline
Limits:
Humans
Language:
En
Journal:
Int J Mol Sci
Year:
2023
Document type:
Article
Affiliation country:
Greece