黑色素瘤中自身免疫介导的黑色素细胞破坏的多个方面。
The many faces of autoimmune-mediated melanocyte destruction in melanoma.
发表日期:2024
作者:
Loredana Ungureanu, Alina Florentina Vasilovici, Salomea-Ruth Halmágyi, Ioana Irina Trufin, Adina Patricia Apostu, Simona Corina Şenilă
来源:
Frontiers in Immunology
摘要:
黑色素瘤是最严重的皮肤癌,其发病率在世界范围内不断增加。黑色素瘤细胞源自正常黑色素细胞,并共享不同的黑色素细胞特异性抗原,白癜风(一种以自身免疫介导的黑色素细胞破坏为特征的皮肤病)中产生免疫反应的抗原相同。本综述的目的是介绍与黑色素瘤发生、进展和治疗相关的自身免疫介导的黑色素细胞破坏。白癜风患者患黑色素瘤的几率似乎较低。另一方面,黑色素瘤患者甚至在远离原发肿瘤的部位也可能出现色素脱失病变,定义为黑色素瘤相关白皮病(MAL)。在接受免疫治疗或靶向治疗的黑色素瘤患者中也发现了药物相关性白皮病 (DAL),它似乎是一个有利的预后因素。临床上,MAL和DAL均可诊断为白癜风,这三种实体之间几乎没有差异。在这篇综述中,文献研究了接受不同疗法治疗的黑色素瘤患者中 DAL 的发生率,并记录了患者的结果,研究表明,接受免疫检查点抑制剂治疗的 DAL 黑色素瘤患者的无病生存期延长。然而,需要进一步的研究来了解自身免疫介导的黑素细胞破坏的动态。版权所有 © 2024 Ungureanu、Vasilovici、Halmágyi、Trufin、Apostu 和 Şenilă。
Melanoma is the most severe form of skin cancer with an incidence that is increasing all over the world. Melanoma cells derive from normal melanocytes and share different melanocyte-specific antigens, the same antigens against which an immune reaction develops in vitiligo, a skin disease characterized by autoimmune-mediated melanocyte destruction. The purpose of this review is to present the autoimmune-mediated melanocyte destruction associated with melanoma development, progression and treatment. Patients with vitiligo seem to have a lower chance of developing melanoma. On the other hand, patients with melanoma can develop depigmented lesions even at distant sites from the primary tumor, defined as melanoma-associated leukoderma (MAL). Drug-associated leukoderma (DAL) was also described in melanoma patients treated with immunotherapy or targeted therapy and it seems to be a favorable prognostic factor. Clinically, MAL and DAL can be diagnosed as vitiligo and there are few differences between these three entities. In this review, the incidence of DAL in melanoma patients treated with different therapies was researched in the literature and patient outcome was recorded, with studies showing a prolonged disease-free survival in melanoma patients with DAL, treated with immune checkpoint inhibitors. Further studies are however needed to understand the dynamics of autoimmune-mediated melanocyte destruction.Copyright © 2024 Ungureanu, Vasilovici, Halmágyi, Trufin, Apostu and Şenilă.