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Infections due to Dysregulated Immunity: An emerging complication of Cancer Immunotherapy

Infections due to Dysregulated Immunity: An emerging complication of Cancer Immunotherapy
Infections due to Dysregulated Immunity: An emerging complication of Cancer Immunotherapy
Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment. However, immune-related adverse events (irAEs) are a common side effect which can mimic infection. Additionally, treatment of irAEs with corticosteroids and other immunosuppressant agents can lead to opportunistic infection, which we have classed as immunotherapy infections due to immunosuppression. However, emerging reports demonstrate that some infections can be precipitated by ICIs in the absence of immunosuppressive treatment, in contrast to the majority of reported cases. These infections are characterised by a dysregulated inflammatory immune response, and so we propose they are described as immunotherapy infections due to dysregulated immunity. This review summarises the rapidly emerging evidence of these phenomena and proposes a new framework for considering infection in the context of cancer immunotherapy.
0040-6376
Morelli, Tommaso
c2dcdf57-69e8-46f0-a5dc-52bcde28a1ab
Fujita, Kohei
72ac3d62-2d18-4689-9ec1-d03147308de9
Redelman-Sidi, Gil
07b8a37e-f92a-4db9-8825-c7b260282f82
Elkington, Paul
60828c7c-3d32-47c9-9fcc-6c4c54c35a15
Morelli, Tommaso
c2dcdf57-69e8-46f0-a5dc-52bcde28a1ab
Fujita, Kohei
72ac3d62-2d18-4689-9ec1-d03147308de9
Redelman-Sidi, Gil
07b8a37e-f92a-4db9-8825-c7b260282f82
Elkington, Paul
60828c7c-3d32-47c9-9fcc-6c4c54c35a15

Morelli, Tommaso, Fujita, Kohei, Redelman-Sidi, Gil and Elkington, Paul (2021) Infections due to Dysregulated Immunity: An emerging complication of Cancer Immunotherapy. Thorax. (doi:10.1136/thoraxjnl-2021-217260).

Record type: Article

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment. However, immune-related adverse events (irAEs) are a common side effect which can mimic infection. Additionally, treatment of irAEs with corticosteroids and other immunosuppressant agents can lead to opportunistic infection, which we have classed as immunotherapy infections due to immunosuppression. However, emerging reports demonstrate that some infections can be precipitated by ICIs in the absence of immunosuppressive treatment, in contrast to the majority of reported cases. These infections are characterised by a dysregulated inflammatory immune response, and so we propose they are described as immunotherapy infections due to dysregulated immunity. This review summarises the rapidly emerging evidence of these phenomena and proposes a new framework for considering infection in the context of cancer immunotherapy.

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Accepted/In Press date: 12 August 2021
e-pub ahead of print date: 4 October 2021

Identifiers

Local EPrints ID: 450969
URI: http://eprints.soton.ac.uk/id/eprint/450969
ISSN: 0040-6376
PURE UUID: 57ef382a-c808-4f23-a771-e8c4b1fd2fe2
ORCID for Paul Elkington: ORCID iD orcid.org/0000-0003-0390-0613

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Date deposited: 27 Aug 2021 16:32
Last modified: 24 Nov 2021 02:43

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Contributors

Author: Tommaso Morelli
Author: Kohei Fujita
Author: Gil Redelman-Sidi
Author: Paul Elkington ORCID iD

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