Immunotherapy for malignant tumors is a hot spot in current research and treatment of cancer. The activation of programmed cell death receptor-1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA)-4 relevant signaling pathway can inhibit the activation of T lymphocytes. Tumor cells can achieve immune escape by activating this signaling pathway. By inhibiting this signaling pathway, immune-checkpoint inhibitors (ICIs) activate T lymphocytes to clear the tumor cells. Therefore, the adverse effects of ICIs are mainly immune-related adverse events (irAEs). The digestive system, including gastrointestinal tract and liver are vital organs of digestion and absorption, metabolism and detoxification, as well as important immune related organs, which are the commonly affected system of irAEs. This review separately explains the incidence, clinical features, diagnosis and treatment of liver and gastrointestinal adverse events in ICIs.
【中文题目：免疫检查点抑制剂相关消化系统不良反应的临床诊治建议】 【中文摘要：恶性肿瘤的免疫治疗是当前肿瘤研究和治疗领域的热点，免疫检查点分子程序性死亡受体-1（programmed cell death receptor-1, PD-1）和细胞毒性T淋巴细胞相关抗原 4（cytotoxic T lymphocyte-associated antigen 4, CTLA-4）相关信号通路的激活可以抑制T淋巴细胞活化，肿瘤细胞通过激活该信号通路实现免疫逃逸。免疫检查点抑制剂（immuno-checkpoint inhibitors, ICIs）通过抑制该信号通路，活化T淋巴细胞发挥机体对肿瘤细胞的清除。因此，ICIs的相关毒性包括免疫相关的不良事件（immune-related adverse effects, irAEs）。消化系统如胃肠道、肝脏作为人体重要的消化吸收器官、代谢解毒器官，同时也是重要的免疫相关器官，是irAEs的常见受累系统。本文将分别对ICIs的肝脏、胃肠道不良反应的发生率、临床表现、诊断和处理分别进行阐述。】 【中文关键词：免疫检查点抑制剂；免疫相关不良反应；肝脏毒性；消化道不良反应】.
Keywords: Gastrointestinal adverse events; Immune-checkpoint inhibitors; Immune-related adverse events; Liver toxicity.