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Nephrotoxicity Ntawm Immune Checkpoint Inhibitors: Kev Ntsuam Xyuas Tsis Zoo Los Ntawm 2013 txog 2020

Feb 02, 2024

NephrotoxicityQee zaus tshwm sim thaum kho nrogImmune checkpoint inhibitors(ICIs). Ob peb txoj kev tshawb fawb sib piv qhov sib txawv ntawm cov tshuaj no. Txoj kev tshawb no tau tsom mus rau kev ua tus yam ntxwv ntawm nephrotoxicity tom qab ICI pib. Cov ntaub ntawv raug muab rho tawm los ntawm US FDA Adverse Event Reporting System (FAERS) database. Kev txheeb xyuas qhov tsis sib xws, suav nrogcov ntaub ntawv qhia(ICs) thiab tshaj tawm qhov sib txawv ntawm qhov sib txawv (RORs), tau ua los txiav txim siab lub raum toxicity ntawm ICIs. Tag nrho ntawm 7,204 tsab ntawv ceeb toom ntawm lub raum tsis zoo tshwm sim (AEs) tau txheeb xyuas hauv FAERS database. Lub raum AEs feem ntau tau tshaj tawm rau nivolumab (46.84%). Cov teeb liab muaj zog tau kuaj pom hauv cov txiv neej cov neeg mob ua ke nrog ICIs. Hauv kev kho mob ntawm ICIs, kev saib xyuas yuav tsum tau them rau cov neeg mob, tshwj xeeb tshaj yog cov txiv neej cov neeg mob, nrog rau mob raum raug mob, nephritis, autoimmune nephritis thiab lwm yam nephrotoxic AEs. Kev siv ICIs yuav ua rau lawv qhov mob hnyav dua.

Ntsiab lus:Cov xwm txheej tsis zoo; Cov Txheej Txheem Tshaj Tawm Tsis Zoo; kev soj ntsuam tsis sib xws; inhibitors tiv thaiv kab mob; nephrotoxicity

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cistanche order

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Taw qhia

Immune checkpoint inhibitors(ICIs) yog ib hom tshuaj tshiab hauv kev kho mob qog noj ntshav. Lawv tau txais koob meej sai rau lawv txoj kev vam meej hauv kev txhim kho cov txiaj ntsig kho mob hauv ntau hom mob qog noj ntshav (Wrangle li al. 2018). Cov chaw kuaj kab mob tiv thaiv kab mob tau tsim cov cell tuag protein 1 txoj hauv kev (PD-1} / PD-L1) thiab cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) ​​ua raws li lub luag haujlwm "brake" hauv kev tiv thaiv kab mob thiab qhia. uas tiv thaiv lub cev tiv thaiv kab mob tuaj yeem rov ua haujlwm T hlwb thiab tshem tawm cov qog nqaij hlav cancer zoo (Ljunggren li al. 2018). Cov ntaub ntawv pov thawj qhia tau tias qhov inhibition ntawm PD-1 txhawb kev tiv thaiv kab mob tiv thaiv kab mob qog noj ntshav (Messenheimer li al. 2017). Tsis tas li ntawd, kev txhim kho ntawm PD-L1 checkpoint inhibitors tau hloov cov toj roob hauv pes uas tsis yog-hlwb-hlwb mob ntsws cancer (NSCLC) kho, nrog 2 kev pom zoo los ntawm US Food and Drug Administration (FDA) ntawm PD-1 inhibitors rau Kev kho thib ob (Sacher thiab Gandhi 2016). Txog cov kev kho mob tshwm sim ntawm CTLA-4, thawj kab kev kho mob nrog nivolumab ntxiv rau ipilimumab tau ua rau lub sijhawm ntev ntawm tag nrho cov ciaj sia taus tshaj li kev kho mob rau cov neeg mob NSCLC, ywj siab ntawm PD-L1 qhia qib (Hellmann li al. 2019 ).

CISTANCHE EXTRACT WITH 25% ECHINACOSIDE AND 9% ACTEOSIDE FOR KIDNEY FUNCTION

Txawm li cas los xij, lubpheej hmoo ntawm cov xwm txheej phem(AEs) ntawm ICIs tau ntxim nyiam hauv kev kho mob.Nephrotoxicityyog ib qho AE ntau heev. Nws yuav ua rau muaj xwm txheej loj thiab tuag taus yog tias kws kho mob tsis paub thiab kho nws sai. Cov xwm txheej tsis zoo rau lub raum tsis tshua muaj tshwm sim, nrog kwv yees li ntawm 2% nrog cov tshuaj tiv thaiv PD{-1/PD-L1 thiab 5% nrog kev sib xyaw ua ke hauv kev tshuaj xyuas theem 2 thiab 3 kev sim, tab sis kev tshawb fawb tsis ntev los no. tau tawm tswv yim tias qhov tshwm sim ntawm mob raum raug mob siab dua li qhov pib qhia (Li et al. 2021).

Nyob rau hauv txoj kev tshawb no, ib qho kev soj ntsuam tsis sib xws tau ua rau tus cwj pwm thiab ntsuas nephrotoxicity cuam tshuam nrog ICI kev tswj hwm siv AE cov ntaub ntawv hauv FDA AdverseKev Tshaj Tawm Txog Txheej Txheem(FAERS) database. Txawm hais tias cov ntaub ntawv hauv FAERS cov ntaub ntawv yuav tsis muaj cov ncauj lus qhia ntxaws ntxaws, txoj hauv kev no tuaj yeem pab tshawb pom cov koom haum tshuaj lom neeg muaj peev xwm.

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Cov ntaub ntawv thiab cov txheej txheem

Tshawb nrhiav kev tsim thiab cov ntaub ntawv

Qhov kev rov qab los no, kev tshawb fawb tshuaj pharmacovigilance yog qhov kev soj ntsuam tsis zoo raws li FAERS cov ntaub ntawv, sau cov ntawv ceeb toom ntawm AEs los ntawm cov neeg siv khoom, cov kws kho mob, cov tuam txhab tshuaj, thiab lwm yam. Nws tso cai rau cov teeb liab tshawb pom thiab qhov muaj pes tsawg leeg ntawm kev sib koom ua ke ntawm cov tshuaj thiab cov ntawv ceeb toom ntawm AEs (Min et al. 2018). Cov ntaub ntawv tawm tswv yim rau txoj kev tshawb fawb no tau muab los ntawm pej xeem tso tawm ntawm FAERS cov ntaub ntawv, suav nrog lub sijhawm txij li thawj peb lub hlis twg xyoo 2013 txog rau lub quarter thib ob ntawm 2020.

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Txheej txheem

Cov tshuaj tau kawm suav nrog cov tshuaj tiv thaiv kab mob rau PD{{0}} (nivolumab thiab pembrolizumab), PD-L1 (atezolizumab, nivolumab thiab durvalumab), thiab CTLA-4 (ipilimumab thiab tremelimumab). Cov npe dav dav thiab cov npe hom tau siv los txheeb xyuas cov ntaub ntawv cuam tshuam nrog ICIs vim tias tsis muaj cov txheej txheem coding zoo rau cov tshuaj. Txoj kev tshawb no suav nrog tag nrho cov mob raum (tsis suav nrog nephropathies) (Cov Lus Qhia Kho Mob rau Kev Tswj Xyuas Kev Ua Haujlwm (MedDRA) code 10038430) thiab tag nrho cov nephropa thies (MedDRA code 10029149) raws li MedDRA version 23.0. Hauv FAERS cov ntaub ntawv, txhua daim ntawv tshaj tawm tau sau npe siv cov lus nyiam (PTs) los ntawm MedDRA, cov lus siv kho mob thoob ntiaj teb tsim los ntawm International Council for Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use.

CISTANCHE EXTRACT WITH 25% ECHINACOSIDE AND 9% ACTEOSIDE FOR KIDNEY FUNCTION

Kev txheeb cais

Disproportionality tshwm sim thaum cov tshuaj txuam nrog ib qho tshwj xeeb AE hauv kev tshawb fawb pharmacovigilance. Ob-los ntawm-ob lub rooj sib tham tau siv los suav cov ntawv ceeb toom AE ntawm cov tshuaj xav tau thiab lwm yam tshuaj (Table 1). Ob txoj hauv kev tshawb nrhiav cov ntaub ntawv, qhia txog qhov sib txawv ntawm qhov sib txawv (RORs) thiab Bayesian kev ntseeg siab tshaj tawm neural networks (BCPNNs) ntawm cov ntaub ntawv cov khoom (ICs), tau siv los xam qhov tsis sib xws.

CISTANCHE EXTRACT WITH 25% ECHINACOSIDE AND 9% ACTEOSIDE FOR KIDNEY FUNCTION

thiab ij {{0}}, i=1,=2, j=1, thiab=2; C yog tag nrho cov ntaub ntawv qhia hauv cov ntaub ntawv, Cij yog tus naj npawb ntawm kev sib txuas ntawm cov tshuaj ICI (i) thiab cov tshuaj tiv thaiv nephrotoxicity (j), Ci yog tag nrho cov ntaub ntawv qhia txog cov tshuaj ICI (i) hauv cov ntaub ntawv thiab Cj yog tag nrho cov ntaub ntawv qhia txog cov tshuaj tiv thaiv nephrotoxicity (j) hauv cov ntaub ntawv. Lub teeb liab tau suav tias yog qhov tseem ceeb yog tias qhov qis qis ntawm 95% kev ntseeg siab lub sijhawm (ROR025) siab dua 1, lossis yog tias qhov qis kawg ntawm 95% kev ntseeg siab lub sijhawm ntawm cov ntaub ntawv tivthaiv (IC025) ntau dua 0. Tag nrho cov kev soj ntsuam tau ua tiav. nrog SAS version 9.4 thiab R version 3.6.3. Kev pom zoo rau kev coj ncaj ncees thiab kev tso cai los koom tsis tau.

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