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Title: Using Autoantibodies to Diagnose Systemic Autoimmune Diseases Triggered by Immune Checkpoint Inhibitors: A Clinical Perspective.
Austin Authors: Flores-Chávez, Alejandra;Brito-Zerón, Pilar;Retamozo, Soledad;Bitoun, Samuel;Fisher, Benjamin A;Liew, David F L ;Suijkerbuijk, Karijn;Chatzidionysiou, Katerina;Suárez-Almazor, María;Lambotte, Olivier;Mariette, Xavier;Ramos-Casals, Manuel;Liew, David 
Affiliation: Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.
Research and Innovation Group in Autoimmune Diseases, Sanitas Digital Hospital, Hospital-CIMA-Centre Mèdic Milenium Balmes Sanitas, Barcelona, Spain.
Department of Rheumatology, Hospital Quirón Salud, Barcelona, Spain.
Université Paris-Saclay, INSERM, UMR 1184, Department of Rheumatology, Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, FHU CARE, Le Kremlin Bicêtre, France.
Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, United Kingdom; National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre and Department of Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.
Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia;
Department of Medical Oncology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Rheumatology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Health Services Research and Section of Rheumatology and Clinical Immunology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Université Paris-Saclay, INSERM, CEA, UMR 1184, Le Kremlin Bicêtre, France; Assistance Publique - Hôpitaux de Paris, Department of Internal Medicine and Clinical Immunology, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
Université Paris-Saclay, INSERM, UMR 1184, Department of Rheumatology, Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, FHU CARE, Le Kremlin Bicêtre, France.
Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain; School of Medicine, Universitat de Barcelona, Spain.
Issue Date: 2022
Publication information: Critical Reviews in Immunology 2022; 42(4)
Abstract: Immunotherapies, such as immune checkpoint inhibitors (ICIs), have significantly advanced the treatment of cancer and other conditions. However, these therapies can also cause immune-related adverse events (irAEs), which are unintended side effects due to their effects on the immune system of the treated patient. These effects can be classified as organ-specific or systemic, with the latter being of particular interest due to their potential overlap with systemic autoimmune diseases (SADs). Autoantibodies, which are proteins produced by the immune system that react with self components, are often used to diagnose and classify SAD. However, the diagnostic value of autoantibodies in the context of systemic irAEs (sirAEs) triggered by ICIs is not well understood. This review aims to evaluate the diagnostic value of conventional autoantibodies in the identification and classification of sirAEs. A comprehensive search of the literature was conducted using the PubMed database, with a focus on articles published in the past 10 years. The results of the review suggest that, although autoantibodies can be useful in the diagnosis and classification of some SAD triggered by ICIs, there is a clear predominance of seronegative irAEs. The lack of traditional autoantibodies may suggest a unique mechanism for sirAEs and increases the already complex diagnostic approach of these manifestations, requiring evaluation by multidisciplinary teams with extensive experience in immunomediated diseases. Further research is needed to fully understand the diagnostic value of autoantibodies in this context and to determine the optimal approach for their detection and interpretation.
DOI: 10.1615/CritRevImmunol.2023047272
Journal: Critical Reviews in Immunology
Start page: 21
End page: 36
PubMed URL: 37022357
Type: Journal Article
Subjects: Immune Checkpoint Inhibitors/adverse effects
Neoplasms/drug therapy
Drug-Related Side Effects and Adverse Reactions/drug therapy
Autoimmune Diseases/diagnosis
Autoimmune Diseases/drug therapy
Appears in Collections:Journal articles

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