scholarly journals Neurological Diseases Associated to Immune Checkpoint Inhibitors

2021 ◽  
Vol 8 (6) ◽  
pp. 01-08
Author(s):  
Felipe Souza
Keyword(s):  
Adverse Effect ◽  
Nervous System ◽  
Clinical Practice ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Neurological Diseases ◽  
Neurological Complications ◽  
Immune Control ◽  
Pubmed Database ◽  
Antibodies Monoclonal

The treatment for cancer has been more widespread and new therapies appear as alternatives in the area to contain the advance of the tumor, having with the immune mechanisms one of the main sources of research and study for a possible advance in the treatment. Checkpoint inhibitors (ICI) are monoclonal therapy, which act by blocking the PD-1, PD-L1 and CTLA-4 molecules, responsible for immune control. However, among the effects caused by therapy, the use of medications is associated with neurological diseases reported as an adverse effect. Neurological complications can affect both the central and the peripheral nervous system, reaching a variety of regions and being related to effects in several diseases. In clinical practice, the report in question shows how the adverse effects of using these therapies work, collaborating with evidence on the use or not of it. This bibliographic review, which used the PUBMED database with the words "antibodies", "monoclonal", "immune control", "checkpoints inhibitors", brings the main neurological diseases associated with therapy, as well as the incidence, symptoms and treatment. Methodology: The present review used as a means of obtaining information the PUBMED platform, in which it was looking for articles using the words "" antibodies "," monoclonal "," immune control "," checkpoints inhibitors ", in addition to fulfilling the year criteria between 2010 and 2020. The language and countries in which the data were obtained were not selected, so information from articles published in several countries was used.

scholarly journals Proposed diagnostic and treatment paradigm for high-grade neurological complications of immune checkpoint inhibitors

2018 ◽  
Vol 6 (5) ◽  
pp. 340-345 ◽  
Author(s):  
Dustin Anderson ◽  
Grayson Beecher ◽  
Nabeela Nathoo ◽  
Michael Smylie ◽  
Jennifer A McCombe ◽  
...  
Keyword(s):  
Nervous System ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Neurological Complications ◽  
High Grade ◽  
Small Cell Lung ◽  
Cytotoxic Lymphocyte ◽  
Programmed Cell Death 1 ◽  
Treatment Paradigm

Abstract Immune checkpoint inhibitors such as antibodies to cytotoxic lymphocyte-associated protein 4 (ipilimumab) and programmed cell-death 1 (pembrolizumab, nivolumab) molecules have been used in non-small cell lung cancer, metastatic melanoma, and renal-cell carcinoma, among others. With these agents, immune-related adverse events (irAEs) can occur, including those affecting the neurological axis. In this review, high-grade neurological irAEs associated with immune checkpoint inhibitors including cases of Guillain-Barré syndrome (GBS) and myasthenia gravis (MG) are analyzed. Based on current literature and experience at our institution with 4 cases of high-grade neurological irAEs associated with immune checkpoint inhibitors (2 cases of GBS, 1 case of meningo-radiculitis, and 1 case of myelitis), we propose an algorithm for the investigation and treatment of high-grade neurological irAEs. Our algorithm incorporates both peripheral nervous system (meningo-radiculitis, GBS, MG) and central nervous system presentations (myelitis, encephalopathy). It is anticipated that our algorithm will be useful both to oncologists and neurologists who are likely to encounter neurological irAEs more frequently in the future as immune checkpoint inhibitors become more widely used.

Central Nervous System Disorders Associated To Immune Checkpoint Inhibitors

2021 ◽  
Vol 17 ◽  
Author(s):  
Felipe Fanine de Souza ◽  
Julia Petry Trevisani ◽  
Letícia Caroline Breis ◽  
Luís Gustavo Marcelino Sizenando ◽  
Marco Antônio Machado Schlindwein ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Neurological Diseases ◽  
Cns Disorders ◽  
Central Nervous System Disorders ◽  
Wide Range ◽  
The Central Nervous System

: New therapies and alternatives for the containment of tumor progression are being proposed for the treatment of cancer. In this context, monoclonal therapies using immune checkpoint inhibitors (ICI) come as a therapeutic proposal. They are responsible for immunological control by blocking PD-1, PD-L1 and CTLA-4 molecules. However, among the effects caused by therapy, the use of medications is associated with neurological diseases reported as an adverse effect, affecting the central nervous system (CNS) and causing a wide range of symptoms. In this regard, the present bibliographic review presents the main CNS disorders associated with this therapy, in addition to the incidence, symptoms and treatment of these diseases.

Capillary-leak syndrome: an unrecognized early immune adverse effect of checkpoint-inhibitors treatment

Immunotherapy ◽  
2021 ◽  
Author(s):  
Ruth Percik ◽  
Asher Nethanel ◽  
Yair Liel
Keyword(s):  
Adverse Effect ◽  
Immune Response ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Endothelial Damage ◽  
Capillary Leak Syndrome ◽  
Capillary Leak ◽  
Cytokine Activation ◽  
Complex Interactions ◽  
Cellular Immune

Capillary-leak syndrome is strongly associated with cytokine activity states. It is an ill-recognized adverse effect of checkpoint inhibitors treatment, which are typically associated with cellular immune response. We describe two patients with capillary leak syndrome following immune checkpoint inhibitors treatment. We present linking mechanisms between checkpoint inhibitors, cellular immunity, cytokine action and endothelial damage. We suggest that capillary-leak syndrome is a unique adverse effect of immunotherapy, resulting from complex interactions between cellular and cytokine activation and that its expression is probably depending on inherent host immune variabilities.

scholarly journals Neurological manifestations associated with SARS-CoV-2 infection: a narrative review

2021 ◽  
Author(s):  
Poliana Rafaela dos Santos Araújo ◽  
Kauan Alves Sousa Madruga ◽  
Bruna Alves Rocha ◽  
Lucas Oliveira Braga
Keyword(s):  
Nervous System ◽  
Meta Analysis ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Narrative Review ◽  
Common Symptom ◽  
Neurological Manifestations ◽  
Cns Involvement ◽  
Pubmed Database ◽  
Critical Patients

Background: Coronavirus disease (COVID-19), once identified, soon spread globally, becoming a pandemic. Although patients present mainly with respiratory complaints, several neurological symptoms have been reported. Symptoms range from headache and nonspecific dizziness to seizures and cerebrovascular disease (CVD). It has also been shown that the severity of the infection is directly proportional to the development of neurological symptoms, especially CVD and changes in mental status. Objective: The present study aims to briefly review the neurological manifestations of COVID-19 and discuss the pathogenic mechanisms of Central Nervous System (CNS) involvement. Methods: This is an exploratory narrative review with a descriptive approach, consisting of an active search for scientific articles in the PubMed database. The descriptors “coronavirus infections”, “COVID-19” and “Nervous system” were used, with the Boolean operators “OR” and “AND”. Eighteen articles of systematic review and meta-analysis were included. Results: CNS manifestations included, among others: encephalitis, encephalopathy, consciousness decrease, headache, dizziness, acute myelitis, and stroke. As for the peripheral nervous system, skeletal muscle damage, chemosensory dysfunction, and Guillain-Barré syndrome were observed, with hyposmia being the most common symptom. CNS involvement may be related to a worse prognosis. Conclusion: The clinical involvement of the nervous system in COVID-19 is not uncommon, and can result in several neurological complications, especially in the most critical patients. The pathophysiological mechanisms of these events still need further investigation. In the meantime, physicians should value extra-respiratory symptoms ranging from hyposmia, to potentially fatal manifestations, such as stroke and encephalopathy.

scholarly journals Chemokine Ligand 13 (CXCL13) in Neuroborreliosis and Neurosyphilis as Selected Spirochetal Neurological Diseases: A Review of Its Diagnostic Significance

2020 ◽  
Vol 21 (8) ◽  
pp. 2927
Author(s):  
Monika Gudowska-Sawczuk ◽  
Barbara Mroczko
Keyword(s):  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Neurological Diseases ◽  
Treponema Pallidum ◽  
High Sensitivity ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Laboratory Diagnostics ◽  
Diagnostic Significance ◽  
Pubmed Database ◽  
Chemokine Ligand

Neuroborreliosis (NB) and neurosyphilis (NS) are abnormal conditions caused by spirochetal bacteria which affect the nervous system. Diagnosis of neuroborreliosis and neurosyphilis is determined by clinical examination of visible symptoms, serum and cerebrospinal fluid (CSF) analysis, and serological detection of antibodies against Borrelia burgdorferi sensu lato and Treponema pallidum, respectively. Establishing a diagnosis may sometimes pose a number of diagnostic difficulties. A potential role of chemokine ligand 13 (CXCL13) as an accurate diagnostic biomarker of intrathecal inflammation has been suggested. In this review, we focused on changes in serum and cerebrospinal fluid concentration of chemokine ligand 13 in selected spirochetal neurological diseases neuroborreliosis and neurosyphilis reported in the available literature. We performed an extensive search of the literature relevant to our investigation via the MEDLINE/PubMed database. It has been proven that CXCL13 determination can provide rapid information regarding central nervous system inflammation in patients with selected spirochetosis. We described that neuroborreliosis and neurosyphilis are associated with an elevated CXCL13 concentration, mainly in the cerebrospinal fluid. Moreover, literature data suggest that CXCL13 determination is the most interesting additional marker for diagnosis and monitoring of neuroborreliosis and neurosyphilis thanks to its high sensitivity. Based on these published findings, we suggest that CXCL13 has high diagnostic utility and may be applied in laboratory diagnostics as a potential diagnostic marker in human spirochetal neurologic diseases.

scholarly journals Progress in Research on SARS-CoV-2 Infection Causing Neurological Diseases and Its Infection Mechanism

2021 ◽  
Vol 11 ◽  
Author(s):  
Lintao Wang ◽  
Zhiguang Ren ◽  
Li Ma ◽  
Yanjie Han ◽  
Wenqiang Wei ◽  
...  
Keyword(s):  
Public Health ◽  
Central Nervous System ◽  
Nervous System ◽  
Neurological Diseases ◽  
Public Health Problem ◽  
Neurological Complications ◽  
Major Public Health Problem ◽  
The Central Nervous System ◽  
The Impact ◽  
Great Harm

COVID-19 has spread rapidly worldwide since its outbreak and has now become a major public health problem. More and more evidence indicates that SARS-CoV-2 may not only affect the respiratory system but also cause great harm to the central nervous system. Therefore, it is extremely important to explore in-depth the impact of SARS-CoV-2 infection on the nervous system. In this paper, the possible mechanisms of SARS-CoV-2 invading the central nervous system during COVID-19, and the neurological complications caused by SARS-CoV-2 infection were reviewed.

scholarly journals 299 Cancer immune control by immune checkpoint inhibitors requires senescence

2019 ◽  
Vol 139 (9) ◽  
pp. S266
Author(s):  
E. Brenner ◽  
B.F. Schörg ◽  
T. Wieder ◽  
F. Hilke ◽  
C. Schroeder ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Immune Control

scholarly journals Overview of Immune Checkpoint Inhibitors Therapy for Hepatocellular Carcinoma, and The ITA.LI.CA Cohort Derived Estimate of Amenability Rate to Immune Checkpoint Inhibitors in Clinical Practice

Cancers ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1689 ◽  
Author(s):  
Edoardo Giannini ◽  
Andrea Aglitti ◽  
Mauro Borzio ◽  
Martina Gambato ◽  
Maria Guarino ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Practice ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Critical Evaluation ◽  
Real Life ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Immune Checkpoints

Despite progress in our understanding of the biology of hepatocellular carcinoma (HCC), this tumour remains difficult-to-cure for several reasons, starting from the particular disease environment where it arises—advanced chronic liver disease—to its heterogeneous clinical and biological behaviour. The advent, and good results, of immunotherapy for cancer called for the evaluation of its potential application also in HCC, where there is evidence of intra-hepatic immune response activation. Several studies advanced our knowledge of immune checkpoints expression in HCC, thus suggesting that immune checkpoint blockade may have a strong rationale even in the treatment of HCC. According to this background, initial studies with tremelimumab, a cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor, and nivolumab, a programmed cell death protein 1 (PD-1) antibody, showed promising results, and further studies exploring the effects of other immune checkpoint inhibitors, alone or with other drugs, are currently underway. However, we are still far from the identification of the correct setting, and sequence, where these drugs might be used in clinical practice, and their actual applicability in real-life is unknown. This review focuses on HCC immunobiology and on the potential of immune checkpoint blockade therapy for this tumour, with a critical evaluation of the available trials on immune checkpoint blocking antibodies treatment for HCC. Moreover, it assesses the potential applicability of immune checkpoint inhibitors in the real-life setting, by analysing a large, multicentre cohort of Italian patients with HCC.

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