clinicaloncologyКлинический случай в онкологииClinical Case in Oncology3034-14773034-4018ОНКОПРАКТИК10.62546/3034-1477-2024-2-3-62-69clinicaloncology-27Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCASE REPORTSРедкое осложнение, ассоциированное c использованием современных иммуноонкологических препаратов, - поражение почекА rare complication, associated with the use of modern immunooncology drugs - kidney injuryОрловаР. В.OrlovaR. V.

199106, Санкт-Петербург, 21-линия В.О., д. 8а; 198255, Санкт-Петербург, пр. Ветеранов, д. 56

7/9 Universitetskaya Emb., 199034; 56 Veteranov Ave., St. Petersburg 193318

БелякН. П.BelyakN. P.

199106, Санкт-Петербург, 21-линия В.О., д. 8а; 198255, Санкт-Петербург, пр. Ветеранов, д. 56

7/9 Universitetskaya Emb., 199034; 56 Veteranov Ave., St. Petersburg 193318

МгарьЕ. А.MgarE. A.

Мгарь Екатерина Андреевна

199106, Санкт-Петербург, 21-линия В.О., д. 8а

Mgar Ekaterina Andreevna

7/9 Universitetskaya Emb., 199034

caterina.odinets@mail.ruФГБОУ ВО «Санкт-Петербургский государственный университет»; СПб ГБУЗ «Городской клинический онкологический диспансер»РоссияSt. Petersburg State University; St. Petersburg City Clinical Oncology DispensaryRussian FederationФГБОУ ВО «Санкт-Петербургский государственный университет»РоссияSt. Petersburg State UniversityRussian Federation202427012025236269Copyright © Орлова Р.В., Беляк Н.П., Мгарь Е.А., 20252025Орлова Р.В., Беляк Н.П., Мгарь Е.А.Orlova R.V., Belyak N.P., Mgar E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncocase.ru/jour/article/view/27

Ингибиторы иммунных контрольных точек (ИКТ), в том числе антиген цитотоксических Т-лимфоцитов 4 (cytotoxic T-lymphocyte antigen 4 – CTLA-4), рецептор запрограммированной гибели 1 (programmed death 1 – PD-1) и его лиганд 1 (PD-ligand-1 – PD-L1), представляют собой современные иммуноонкологические препараты, которые на сегодняшний день продемонстрировали эффективность лечения при ряде злокачественных новообразований. Механизм действия ингибиторов ИКТ заключается в потенцировании иммунного отчета за счет устранения тормозящего влияния опухолевых клеток на активацию Т-лимфоцитов. Однако чрезмерная активация иммунной системы может стать причиной развития иммуноопосредованных нежелательных явлений (иоНЯ) со стороны ряда органов и систем, в том числе и почек. Несмотря на то, что иммуноопосредованное поражение почек на фоне терапии ингибиторами ИКТ развивается относительно редко, оно может быть достаточно серьезным и определять прогноз пациента, что обусловливает необходимость ранней диагностики и своевременного начала лечения. В связи с этим приобретает особую актуальность информированность о проявлениях иоНЯ со стороны почек на фоне иммунотерапии не только онкологов и нефрологов, но и врачей других специальностей

Immune checkpoint inhibitors (ICIs), including cytotoxic T-lymphocyte associated antigen 4 (CTLA-4) and programmed death protein 1 (PD-1) or its ligand (PD-L1), are a new generation of immuno-oncological drugs that to date have demonstrated efficacy in a number of malignancies. The mechanism of ICIs action consist in the potentiation of the immune response by eliminating the tumor cells inhibitory effect on the T-lymphocytes activation. However, excessive immune system activation can cause the development of a special class of immune-related adverse events (irAEs) involved a wide variety of organs and systems, including the kidneys. Despite the fact that immunomediated kidney injury caused by ICI therapy develops quite rarely (2–15%), it can be serious and determine the patient’s prognosis, which necessitates early diagnosis and timely start of treatment. In this regard, awareness of the manifestations of ICI-associated renal irAEs is particularly relevant not only for oncologists and for nephrologists, but for doctors of other specialties.

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The authors declare that there are no conflicts of interest present.