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Archive > Volume 30 Issue 3 > 2023,30(3):196-203. DOI:10.3872/j.issn.1007-385X.2023.03.002 Prev Next
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Mechanism and treatment strategies of immune checkpoint inhibitors related biliary type hepatotoxicity
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Abstract:
Immune checkpoint inhibitors (ICIs) have attracted much attention in recent years due to their remarkable efficacy in tumor treatment. Immune mediated hepatotoxicity (IMH) caused by ICIs is a kind of common immune related adverse events (irAEs).However, a subtype of IMH, biliary type IMH (BIMH) is a rare irAE with insufficient cognition and lack of standardized diagnosis andtreatment, which has hidden clinical dangers. The patient with BIMH is characterized by significant increase of bile duct enzymes and hyperbilirubinemia. The histopathological manifestations of BIMH are bile duct inflammation, bile duct injury and disappearance. The patients with BIMH in cholestasis stage have poor response to immunosuppressive therapy and their prognoses are poor. Improving the understanding of BIMH, early diagnosis and early intervention are the keys to improve the prognosis of patients with BIMH. Constant understanding of the epidemiological characteristics, clinical characteristics, histopathological characteristics, pathogenesis and problems in the overall management of BIMH will help to put forward more effective diagnosis and treatment strategies for BIMH.
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