NDLI: Survenue d’un diabète de type 1 (DT1) fulminant lié aux immunothérapies du mélanome

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Survenue d’un diabète de type 1 (DT1) fulminant lié aux immunothérapies du mélanome

Content Provider	Semantic Scholar
Author	Métayer-Amelot, L. Dessart, P. D. Vincent, Fabienne Pineau‐ Dorange, Anne Maillard, Hervé Duquenne, M.
Copyright Year	2016
Abstract	Le pembrolizumab (anticorps monoclonal anti-PD1) et l’ipilimumab (anticorps anti-CTLA4) sont des immunotherapies prometteuses dans le melanome non resecable ou metastatique. Ils potentialisent l’activation, la proliferation et l’infiltration des lymphocytes T dans les cellules tumorales, entrainant leur destruction. Ces traitements engendrent de nombreuses manifestations auto-immunes. Une femme de 83 ans, atteinte d’un melanome de la fosse nasale avec metastases ganglionnaires et osseuses, est initialement traitee par 4 cures de pembrolizumab, arretees du fait d’une insuffisance renale. Devant la progression locale, elle a recu une cure d’ipilimumab un mois avant de presenter une acidocetose (pH 7,22, bicarbonates En 2015, Hughes et al. ont decrit 5 cas de DT1, survenus entre 1 semaine et 5 mois apres traitement par pembrolizumab. Un malade avait aussi recu de l’ipilimumab. Gaudy et al. ont egalement presente un cas de diabete fulminant apres ipilimumab et pembrolizumab. Chez la souris, le blocage de PD1 peut entrainer un DT1, par reaction auto-immune des lymphocytes T envers les cellules beta-pancreatiques. Une reduction de l’expression de PD1 dans les lymphocytes CD4 a aussi ete mise en evidence chez des diabetiques de type 1. De plus, certains variants genotypiques de CTLA4 sont associes a un surrisque de DT1. En conclusion, le blocage de CTLA4 et PD1 majore fortement le risque de developper un DT1.
File Format	PDF HTM / HTML
DOI	10.1016/j.ando.2016.07.780
Alternate Webpage(s)	https://www.congres-sfe.com/2016/eposters/7f18cc16-707f-11e6-9efb-d97ff2406a52.pdf
Alternate Webpage(s)	https://doi.org/10.1016/j.ando.2016.07.780
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article

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