实用医学杂志2025，Vol.41Issue(21)：3315-3321,7.DOI:10.3969/j.issn.1006-5725.2025.21.003
免疫检查点抑制剂相关肾损伤的临床病理类型与发病机制
Clinical pathological types and pathogenesis of immune checkpoint inhibitor-related kidney injury
摘要
Abstract
Immune checkpoint inhibitors(immune checkpoint inhibitors,ICIs),as new anti-tumour drugs,have significantly improved the prognosis of tumour patients by blocking the endogenous immune inhibitory signals and activating the immune response of T cells against tumours.However,the immune-related adverse events(irAEs)they cause have become a significant concern.irAEs can affect multiple organ systems,including the kidneys.Among these,immune checkpoint inhibitor-associated acute kidney injury(ICI-AKI)represents the most common renal toxicity manifestation.The most common pathological type is acute interstitial nephritis(AIN).Non-AIN types,such as glomerular diseases and thrombotic microangiopathy,can also occur.The pathogenesis of ICI-AKI is complex,involving immune tolerance imbalance,abnormal activation of autoreactive T cells,autoantibody produc-tion,and inflammatory cytokines.ICI-AKI typically responds well to early corticosteroid therapy,with most patients achieving partial or complete renal recovery.Therefore,the timely evaluation,precise diagnosis,and standardized management of suspected cases hold crucial clinical value.A deep understanding of the clinical and pathological features and immunological mechanisms of ICI-related renal injury is the key to optimizing early identification,accurate diagnosis,and effective management.This review aims to systematically summarize the key pathological findings of current ICI-related kidney injury and deeply explore its immunological mechanisms of occurrence and development,providing theoretical basis and guidance for clinical practice.关键词
免疫检查点抑制剂/免疫相关不良事件/急性肾损伤/肾毒性/病理类型Key words
immune checkpoint inhibitors/immune-related adverse events/acute kidney injury/nephrotoxicity/pathological type分类
临床医学引用本文复制引用
肖慧玲,何伟春..免疫检查点抑制剂相关肾损伤的临床病理类型与发病机制[J].实用医学杂志,2025,41(21):3315-3321,7.基金项目
国家自然科学基金项目(编号:31571169) （编号:31571169）
