Lymphocytic Colitis Secondary to Ipilimumab Treatment

Varona, Alejandro García; Odze, Robert D.; Makrauer, Frederick L.

doi:10.1002/ibd.22846

Cited by 28 publications

(16 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Histopathological examination is notable for active colitis characterised by marked mixed inflammatory cell infiltrates in the lamina propria consisting of neutrophils, lymphocytes, plasma cells and eosinophils. Foci of neutrophilic cryptitis, crypt abscesses, glandular destruction and erosions of the mucosal surface can be found with occasional ulcers (Figure ) . These inflammatory changes tend to be more diffuse (75%) and less commonly patchy .…”

Section: Diagnosismentioning

confidence: 99%

Systematic review: colitis associated with anti‐CTLA‐4 therapy

Gupta

Felice

Loftus

et al. 2015

Aliment Pharmacol Ther

249

221

View full text Add to dashboard Cite

SUMMARY BackgroundCytotoxic T-lymphocyte-associated protein-4 (CTLA-4) has an important role in T-cell regulation, proliferation and tolerance. Anti-CTLA-4 agents, such as ipilimumab and tremelimumab, have been shown to prolong overall survival in patients with metastatic melanoma, and their use is being investigated in the treatment of other malignancies. Their novel immunostimulatory mechanism, however, predisposes patients to immune-related adverse effects, of which gastrointestinal effects such as diarrhoea and colitis are the most common.

show abstract

Section: Diagnosismentioning

confidence: 99%

Systematic review: colitis associated with anti‐CTLA‐4 therapy

Gupta

Felice

Loftus

et al. 2015

Aliment Pharmacol Ther

249

221

View full text Add to dashboard Cite

show abstract

“…In contrast to the chronic colitis-associated histological alterations observed in IBD, anti-CTLA-4 and anti-PD-1 colitis are characterized by neutrophilic inflammation or a mononuclear expansion in the lamina propria and increased intraepithelial lymphocytes. [137][138][139] In most patients with immunotherapy-induced colitis, disease remission is achieved by discontinuing the drug, 134 but patients are likely to relapse when restarting the same drug. 137,140 Development of recurrent colitis has been observed in patients without a past medical history of intestinal inflammation who had stopped anti-CTLA-4 or anti-PD-1 therapy for multiple months.…”

Section: Pd-1 and Intestinal Homeostasismentioning

confidence: 99%

Tipping the balance: inhibitory checkpoints in intestinal homeostasis

et al. 2019

View full text Add to dashboard Cite

The small intestinal and colonic lamina propria are populated with forkhead box P3 (FOXP3) + CD4 + regulatory T cells (Tregs) and interleukin-10-producing T cells that orchestrate intestinal tolerance to harmless microbial and food antigens. Expression of coinhibitory receptors such as CTLA-4 and PD-1 serve as checkpoints to these cells controlling their T-cell receptor (TCR)-mediated and CD28-mediated activation and modulating the phenotype of neighboring antigen presenting cells. Recent discoveries on the diversity of co-inhibitory receptors and their selective cellular expression has shed new light on their tissue-dependent function. In this review, we provide an overview of the co-inhibitory pathways and checkpoints of Treg and effector T cells and their mechanisms of action in intestinal homeostasis. Better understanding of these inhibitory checkpoints is desired as their blockade harbors clinical potential for the treatment of cancer and their stimulation may offer new opportunities to treat chronic intestinal inflammation such as inflammatory bowel disease.

show abstract

“…Of the 1892 unique studies identified using our search criteria, 61 studies fulfilled our inclusion criteria and were included in the qualitative analysis (38 full text articles, 23 in abstract form) . Results of our search strategy are depicted in Figure .…”

Section: Resultsmentioning

confidence: 99%

Systematic review and case series: flexible sigmoidoscopy identifies most cases of checkpoint inhibitor‐induced colitis

Wright

Piper

Bishu

et al. 2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Summary Background Immune checkpoint inhibitors are used in the treatment of multiple advanced stage cancers but can induce immune‐mediated colitis necessitating treatment with immunosuppressive medications. Diagnostic colonoscopy is often performed but requires bowel preparation and may delay diagnosis and treatment. Sigmoidoscopy can be performed rapidly without oral bowel preparation or sedation. Aims Characterize the colonic distribution of immune‐mediated colitis to determine the most efficient endoscopic approach. Methods A systematic review of checkpoint inhibitor‐induced colitis case reports and series was conducted in both PubMed and Embase through 3 January 2017. A single centre retrospective chart review of patients who underwent endoscopic evaluation for diarrhoea after treatment with a checkpoint inhibitor (ipilimumab, nivolumab or pembrolizumab) between 1 January 2011 and 3 January 2017 was performed. Clinical, endoscopic and histologic data were collected. Results A detailed systematic review resulted in 61 studies, in which 226 cases of colitis were diagnosed by lower endoscopy (125 colonoscopy, 101 sigmoidoscopy). Only four patients had isolated findings proximal to the left colon. In our centre, 31 patients had histologic features of checkpoint inhibitor‐induced colitis, for which 29 patients had complete data. The left colon was involved in all cases. Sigmoidoscopy would be sufficient to diagnose >98% of reported cases of checkpoint inhibitor‐mediated colitis diagnosed by lower endoscopy. Conclusions Moderate to severe checkpoint inhibitor‐induced colitis involves the left colon in the majority of cases (>98%). Sigmoidoscopy should be the initial endoscopic procedure in the evaluation of this condition.

show abstract

Lymphocytic Colitis Secondary to Ipilimumab Treatment

Cited by 28 publications

References 7 publications

Systematic review: colitis associated with anti‐CTLA‐4 therapy

Systematic review: colitis associated with anti‐CTLA‐4 therapy

Tipping the balance: inhibitory checkpoints in intestinal homeostasis

Systematic review and case series: flexible sigmoidoscopy identifies most cases of checkpoint inhibitor‐induced colitis

Contact Info

Product

Resources

About