ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12828ometendo-12828Research ArticleОБЗОРЫREVIEWSКоррекция эндокринных осложнений онкоиммунотерапииCorrection of endocrine complications of oncoimmunotherapyhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна – доктор медицинских наук.

117036, Москва, ул. Дмитрия Ульянова, д. 11

Scopus Author ID: 55655098500; Researcher ID: T-9424-2018

Ekaterina A. Pigarova - MD, PhD.

11 Dm. Ulyanova street, 117036 Moscow

Scopus Author ID: 55655098500; Researcher ID: T-9424-2018

kpigarova@gmail.comhttps://orcid.org/0000-0003-0047-7223ШутоваА. С.ShutovaA. S.

Шутова Александра Сергеевна – аспирант.

Москва

Aleksandra S. Shutova - MD, postgraduate student.

Moscow

shutova.aleksandra@gmail.comhttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна - доктор медицинских наук.

Москва

Larisa K. Dzeranova - MD, PhD.

Moscow

dzeranovalk@yandex.ruНациональный медицинский исследовательский центр эндокринологии Министерства здравоохранения Российской ФедерацииРоссияEndocrinology Research CentreRussian Federation202220032023194418430Copyright © Пигарова Е.А., Шутова А.С., Дзеранова Л.К., 20232023Пигарова Е.А., Шутова А.С., Дзеранова Л.К.Pigarova E.A., Shutova A.S., Dzeranova L.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12828

За последние несколько лет иммунотерапия с помощью ингибиторов  иммунных контрольных точек (ИИКТ) стала эффективным средством лечения многих злокачественных новообразований. Иммунные контрольные точки также играют решающую роль в поддержании иммунологической толерантности и предотвращении аутоиммунных заболеваний. Вмешательство в этот механизм может вызвать иммуноопосредованные нежелательные явления (иНЯ), затрагивающие множество органов в организме и нарушающие жизненно важные звенья метаболизма. Эндокринопатии являются одними из наиболее частых аутоиммунных нежелательных явлений (АИНЯ), связанных с терапией ИИКТ. Учитывая уникальную природу нежелательных явлений, вызываемых применением препаратов ИИКТ, требуется многопрофильный командный подход для эффективного ведения пациентов, минимизации осложнений, связанных с токсичностью  препаратов, и полной реализации терапевтического потенциала этого метода лечения. Принимая во внимание сложность выявления неспецифических симптомов, важность последующего наблюдения и своевременного вмешательства в случае выявления токсичности, необходимы регулярный клинический и лабораторный мониторинг, информирование пациентов и врачей о вариантах эндокринологических нежелательных явлений и их лечении. Если неэндокринные иНЯ часто требуют прекращения иммунотерапии и обычно разрешаются иммуносупрессивной терапией высокими дозами глюкокортикоидов, эндокринные иНЯ обычно не требуют прекращения лечения ИИКТ и редко нуждаются в иммуносупрессивной терапии, но при этом редко регрессируют и поэтому требуют длительного лечения.

Over the years, immunotherapy with immune checkpoint inhibitors (ICI) has become an effective treatment for malignant neoplasms. However, checkpoints play a crucial role in immunological tolerance and prevention of autoimmune diseases. Interfering with this mechanism can cause immune-related adverse events (IRAEs) that affect multiple organs in the body. Endocrinopathies are among the most common IRAES associated with ICI therapy. Given the unique nature of adverse events caused by the use of ICI drugs, a multidisciplinary team approach is required to effectively manage patients, minimize complications associated with drug toxicity, and fully realize the therapeutic potential of this treatment method. Taking into account the difficulty of detecting nonspecific symptoms, the importance of follow-up and timely intervention in case of toxicity detection, regular clinical and laboratory monitoring is necessary, as well as informing patients and doctors about the variants of endocrine adverse events and their treatment. While non-endocrine IRAES often require discontinuation of immunotherapy and are usually resolved by immunosuppressive therapy with high doses of glucocorticoids, endocrine IRAES usually do not need discontinuation of ICI treatment and rarely require immunosuppressive therapy, but seldomly regress and therefore demand a long-term treatment.

ингибиторы иммунных контрольных точекэндокринологические аутоиммунные нежелательные явлениягипофизитнадпочечниковая недостаточностьцентральный несахарный диабеттиреоидитгипокальциемиягипопаратиреозгипонатриемиясахарный диабетонкоиммунотерапияипилимумабниволумабimmune checkpoint inhibitorsendocrine autoimmune adverse eventshypophysitisadrenal insufficiencycentral diabetes insipidusthyroiditishypocalcemiahypoparathyroidismhyponatremiadiabetes mellituscancer immunotherapyipilimumabnivolumabReferencesПигарова Е.А., Дзеранова Л.К., Нуралиева Н.Ф., Мельниченко Г.А. Диагностика и лечение эндокринологических осложнений иммунотерапии онкологических заболеваний // Ожирение и метаболизм. — 2018. — Т. 15. — №3. — С. 49-58. doi: https://doi.org/10.14341/omet9834Pigarova EA, Dzeranova LK, Nuralieva NF, Mel'nichenko GA. Diagnosis and treatment of endocrinological complications of immunotherapy of oncological diseases. Obesity and metabolism. 2018;15(3):49-58. 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The authors declare that there are no conflicts of interest present.