Sjögren's Syndrome as an Immune-related Adverse Event of Nivolumab Treatment for Gastric Cancer

Higashi, T; Miyamoto, Hideaki; Yoshida, Ryoji; Furuta, Yoshikazu; Nonomura, Katsuya; Naoe, Hideaki; Naito, Hisaki; Nakayama, Hideki; Tanaka, Motohiko

doi:10.2169/internalmedicine.4701-20

Cited by 12 publications

(2 citation statements)

References 14 publications

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“…In a study on ICI-induced Sicca syndrome, most infiltrating cells were T cells, with more CD4 + T cells than CD8 + T cells and only a few CD20 + B cells [98]. A histological study of the lower lip mucosa revealed that although aggregated CD20 + B cells and CD3 + T cells were observed, T cells were predominant and the CD8 + T cell was more frequent than the CD4 + T cell [100]. This indicates that much lower levels of B cells infiltrate the salivary gland in ICI-induced Sicca syndrome compared with pSS.…”

Section: Induction Of Sicca Syndrome By Icismentioning

confidence: 99%

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Yura

Hamada

2022

Cancers

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Conventional chemotherapy and targeted therapies have limited efficacy against advanced head and neck squamous cell carcinoma (HNSCC). The immune checkpoint inhibitors (ICIs) such as antibodies against CTLA-4, PD-1, and PD-L1 interrupt the co-inhibitory pathway of T cells and enhance the ability of CD8+ T cells to destroy tumors. Even in advanced HNSCC patients with recurrent diseases and distant metastasis, ICI therapy shows efficiency and become an effective alternative to conventional chemotherapy. However, as this therapy releases the immune tolerance state, cytotoxic CD8+ T cells can also attack organs and tissues expressing self-antigens that cross-react with tumor antigens and induce immune-related adverse events (irAEs). When patients with HNSCC are treated with ICIs, autoimmune diseases occur in multiple organs including the skin, digestive tract, endocrine system, liver, and respiratory tract. Treatment of various malignancies, including HNSCC, with ICIs may result in the appearance of oral irAEs. In the oral cavity, an oral lichenoid reaction (OLR) and pemphigoid develop. Sicca syndrome also occurs in association with ICIs, affecting the salivary glands to induce xerostomia. It is necessary to elucidate the pathogenic mechanisms of these intractable diseases that are not seen with conventional therapy. Early diagnosis and appropriate approaches to irAEs are needed for efficient treatment of advanced HNSCC by ICIs.

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Section: Induction Of Sicca Syndrome By Icismentioning

confidence: 99%

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Yura

Hamada

2022

Cancers

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“…The mechanism of ICI-induced xerostomia is considered as an impairment of the PD-1/PD-L1 pathway caused by ICIs that trigger the activation of T-lymphocytes, leading to infiltration of the salivary gland epithelium [ 8 , 9 ]. As a result, it is suggested that there is a lack of the salivary acinar cells and salivary dysfunction is caused [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Radiological imaging features of the salivary glands in xerostomia induced by an immune checkpoint inhibitor

et al. 2020

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The clinical features of xerostomia induced by immune checkpoint inhibitors (ICI) are similar to those of Sjögren’s syndrome (SS), whereas the immunohistological and serological features are known to differ from those of SS. However, the radiologic imaging features of salivary glands are not yet well known. We report a case of a 56-year-old male patient diagnosed with ICI-induced xerostomia. The patient underwent various imaging examinations to investigate the condition of the salivary glands, which indicated the following: (1) less specific findings on contrast-enhanced computed tomography, (2) mixed with intermediate and low signal intensity on both T1-weighted and fat-suppressed T2-weighted magnetic resonance imaging and poor “salt and pepper” appearance on magnetic resonance sialography, and (3) multiple ovoid hypoechoic areas with hyperechoic bands without acute sialadenitis on ultrasound. These radiologic imaging findings suggested remarkable lymphocyte infiltration, which could be a characteristic of ICI-induced xerostomia.

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Sjögren's Syndrome as a Proof of Concept of the Hyperstimulation Syndrome

Borba,

Shoenfeld

2024

Autoimmune Disorders

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Sjögren's Syndrome as an Immune-related Adverse Event of Nivolumab Treatment for Gastric Cancer

Cited by 12 publications

References 14 publications

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Oral Immune-Related Adverse Events Caused by Immune Checkpoint Inhibitors: Salivary Gland Dysfunction and Mucosal Diseases

Radiological imaging features of the salivary glands in xerostomia induced by an immune checkpoint inhibitor

Sjögren's Syndrome as a Proof of Concept of the Hyperstimulation Syndrome

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