Rapid granulomatosis with polyangiitis induced by immune checkpoint inhibition

打完免疫療法長Wegner`s ........蠻有趣的

"Abatacept, a functional counterpart of ipilimumab, is composed of a modified Fc-region of IgG1 and the ligand-binding domain of CTLA4, which leads to CD80/ 86 inhibition on APCs. Of interest is an open-label trial in 20GPA patients treated with abatacept that reported disease

improvement in 18 patients (90%)"

"Based on our findings, one could hypothesize that ipilimumab induced PR3-ANCA production, which set the stage for the development of GPA that was rapidly unleashed by pembrolizumab treatment. Together with existing data on PD1 polymorphism in GPA and on aberrant expression of PD1 on Th cells in GPA, this report highlights the important role of PD1 in the development of GPA. "

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