TY - JOUR
T1 - Immune checkpoint inhibitors and their interaction with proton pump inhibitors–related interstitial nephritis
AU - Miao, Jing
AU - Herrmann, Sandra M.
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy and outcomes, leading to an expanding use in millions of patients worldwide. However, they can cause a spectrum of immune-related adverse events (irAEs). Essentially, any organs can be affected by irAEs, which have emerged as therapy-limiting side effects. In the kidneys, ICI-associated acute interstitial nephritis (ICI-AIN) leads to acute kidney injury (AKI) in 2%–5% of patients on ICI therapy. AKI associated with ICI therapy pathologically presents with AIN in nearly 90% of the cases, but the pathophysiology of ICI-AIN remains to be defined. The generation of autoreactive T cells in patients receiving AIN-inducible drugs, such as proton pump inhibitors (PPIs), is one of the leading theories, supported by a higher incidence of ICI-AIN in patients on these AIN-inducible drugs. In this review, we will discuss our understanding of the incidence, potential pathophysiological mechanisms, clinical presentations, risk factors, diagnosis, and management of PPI-related AIN and its interaction with ICI therapy.
AB - Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy and outcomes, leading to an expanding use in millions of patients worldwide. However, they can cause a spectrum of immune-related adverse events (irAEs). Essentially, any organs can be affected by irAEs, which have emerged as therapy-limiting side effects. In the kidneys, ICI-associated acute interstitial nephritis (ICI-AIN) leads to acute kidney injury (AKI) in 2%–5% of patients on ICI therapy. AKI associated with ICI therapy pathologically presents with AIN in nearly 90% of the cases, but the pathophysiology of ICI-AIN remains to be defined. The generation of autoreactive T cells in patients receiving AIN-inducible drugs, such as proton pump inhibitors (PPIs), is one of the leading theories, supported by a higher incidence of ICI-AIN in patients on these AIN-inducible drugs. In this review, we will discuss our understanding of the incidence, potential pathophysiological mechanisms, clinical presentations, risk factors, diagnosis, and management of PPI-related AIN and its interaction with ICI therapy.
KW - acute kidney injury
KW - immune checkpoint inhibitors
KW - immune-related adverse events
KW - interstitial nephritis
KW - proton pump inhibitors
UR - http://www.scopus.com/inward/record.url?scp=85177466335&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85177466335&partnerID=8YFLogxK
U2 - 10.1093/ckj/sfad109
DO - 10.1093/ckj/sfad109
M3 - Review article
AN - SCOPUS:85177466335
SN - 2048-8505
VL - 16
SP - 1834
EP - 1844
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
IS - 11
ER -