medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2022-31-28-34medalphabet-2938Research ArticleСтатьиАнти-PD-1 – индуцированный сахарный диабет 1 типа у больного с рецидивирующим плоскоклеточным раком ротоглоткиAnti-PD‑1-induced type 1 diabetes mellitus in patient with recurrent oropharyngeal squamous cell cancerhttps://orcid.org/0000-0001-8723-5897ЛьяноваА. А.LianovaA. A.

Льянова Аза Ахметовна, к.м.н., врач-онколог отделения противоопухолевой лекарственной терапии

Ростов-на-Дону

Lianova Aza A., PhD Med, oncologist at Dept of Antitumor Drug Therapy

Rostov-on-Don

blackswan11@mail.ruhttps://orcid.org/0000-0002-4822-5044ВладимироваЛ. Ю.VladimirovaL. Yu.

Владимирова Любовь Юрьевна, д.м.н., проф., рук. отдела лекарственного лечения опухолей

Ростов-на-Дону

Vladimirova Lyubov Yu., DM Sci, professor, head of Dept of Drug Treatment of Tumors

Rostov-on-Don

lubovurievna@gmail.comhttps://orcid.org/0000-0001-7793-9794АбрамоваН. А.AbramovaN. A.

Абрамова Наталия Александровна, к.м.н., с.н.с. отдела лекарственного лечения опухолей

Ростов-на-Дону

Abramova Natalia A., PhD Med, senior researcher at Dept of Drug Treatment of Tumors

Rostov-on-Don

pylulkin@mail.ruhttps://orcid.org/0000-0002-1957-4931ТепляковаМ. А.TeplyakovaM. A.

Теплякова Мария Андреевна, врач-онколог отделения противоопухолевой лекарственной терапии

Ростов-на-Дону

Teplyakova Maria A., oncologist at Dept of Antitumor Drug Therapy

Rostov-on-Don

teplyakova0308@gmail.comhttps://orcid.org/0000-0003-4865-8832ПоповаИ. Л.PopovaI. L.

Попова Ирина Леонидовна, к.м.н., с.н.с. отдела лекарственного лечения опухолей

Ростов-на-Дону

Popova Irina L., PhD Med, senior researcher at Dept of Drug Treatment of Tumors

Rostov-on-Don

sofira09@rambler.ruhttps://orcid.org/0000-0001-5139-2639ТихановскаяН. М.TikhanovskayaN. M.

Тихановская Наталья Михайловна, врач-онколог отделения противоопухолевой лекарственной терапии

Ростов-на-Дону

Tikhanovskaya Natalia M., oncologist at Dept of Antitumor Drug Therapy

Rostov-on-Don

ntihanovskaya@mail.ruhttps://orcid.org/0000-0003-0965-0264СторожаковаА. Э.StorozhakovaA. E.

Сторожакова Анна Эдуардовна, к.м.н., врач-онколог отделения противоопухолевой лекарственной терапии

Ростов-на-Дону

Storozhakova Anna E., PhD Med, oncologist at Dept of Antitumor Drug Therapy

Rostov-on-Don

maymur@list.ruhttps://orcid.org/0000-0002-5964-2513РядинскаяЛ. А.RyadinskayaL. A.

Рядинская Людмила Алексеевна, к.м.н., врач-онколог отделения  противоопухолевой лекарственной терапии

Ростов-на-Дону

Ryadinskaya Lyudmila A., PhD Med, oncologist at Dept of Antitumor Drug Therapy

Rostov-on-Don

riadinskaya10@mail.ruhttps://orcid.org/0000-0003-0075-6935УдаленковаИ. А.UdalenkovaI. A.

Удаленкова Ирина Александровна, к.м.н., врач отделения противоопухолевой лекарственной терапии

Ростов-на-Дону

Udalenkova Irina A., PhD Med, oncologist at Dept of Antitumor Drug Therapy

Rostov-on-Don

fortum10@rambler.ruhttps://orcid.org/0000-0003-0158-3757КалабановаЕ. А.KalabanovaE. A.

Калабанова Елена Александровна, к.м.н., с.н.с. отдела лекарственного лечения опухолей

Ростов-на-Дону

Kalabanova Elena A., PhD Med, senior researcher of the Dept of Drug Treatment of Tumors

Rostov-on-Don

alenakalabanova@mail.ruhttps://orcid.org/0000-0002-6937-0590ТрифановД.TrifanovD.

Трифанов Дмитрий, к.м.н.

 г. Ньюарк

Trifanov Dmitry, MD, PhD Med

Newark, DE

trifanov@yandex.ruФГБУ «Национальный медицинский исследовательский центр онкологии» Минздрава РоссииРоссияNational Medical Research Centre of OncologyRussian FederationБольница Christiana CareСоединённые Штаты АмерикиChristiana Care HospitalUnited States202211012023031Диагностика и онкотерапия (4)2834Copyright © Льянова А.А., Владимирова Л.Ю., Абрамова Н.А., Теплякова М.А., Попова И.Л., Тихановская Н.М., Сторожакова А.Э., Рядинская Л.А., Удаленкова И.А., Калабанова Е.А., Трифанов Д., 20232023Льянова А.А., Владимирова Л.Ю., Абрамова Н.А., Теплякова М.А., Попова И.Л., Тихановская Н.М., Сторожакова А.Э., Рядинская Л.А., Удаленкова И.А., Калабанова Е.А., Трифанов Д.Lianova A.A., Vladimirova L.Y., Abramova N.A., Teplyakova M.A., Popova I.L., Tikhanovskaya N.M., Storozhakova A.E., Ryadinskaya L.A., Udalenkova I.A., Kalabanova E.A., Trifanov D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/2938

Ингибиторы иммунных контрольных точек, нацеленные на запрограммированный лиганд гибели клеток PD-L1, стали крупным прорывом в лечении многих онкологических заболеваний. Ниволумаб – это антитело, избирательно блокирующее рецептор PD‑1 на поверхности цитотоксических Т-клеток для предотвращения подавления регуляции иммунного ответа. Известно, что ингибиторы иммунных контрольных точек могут вызывать так называемые иммуноопосредованные нежелательные явления, в том числе со стороны эндокринной системы. Сахарный диабет 1 типа является одним из тяжелых редких и потенциально опасных для жизни иммуноопосредованных нежелательных явлений, встречающихся менее чем у 1% пациентов, получающих лечение ингибиторами иммунных контрольных точек. Хотя общая частота сахарного диабета 1 типа, связанного с ингибитором PD‑1, относительно низка, тем не менее он имеет молниеносное течение и может представлять потенциальную угрозу для жизни пациентов, если не будут проведены своевременная диагностика и лечение. Поскольку ингибиторы PD‑1 широко используются для лечения многих злокачественных заболеваний, осложнения в виде диабета 1 типа должны привлекать внимание врачей. Кроме того, нельзя не учитывать тот факт, что в ходе лечения врачи должны помогать пациентам лучше распознавать симптомы гипергликемии или диабетического кетоацидоза, что требует тщательного наблюдения за ними во время лечения, регулярного мониторинга уровня глюкозы в плазме крови, оперативного выявления и правильной диагностики и лечения диабета. 

Immune checkpoint inhibitors targeting a programmed cell death ligand (PD-L1) have been a major breakthrough in the treatment of many cancers. Nivolumab is an antibody that selectively blocks the PD‑1 receptor on the surface of cytotoxic T-cells to prevent downregulation of the immune response. Immune checkpoint inhibitors can cause immune-related adverse events, including endocrine ones. Type 1 diabetes mellitus is one of the severe rare and potentially lethal immune-related adverse events diagnosed in less than 1% of patients receiving immune checkpoint inhibitors. The total incidence of type 1 diabetes mellitus associated with the PD‑1 inhibitor is relatively low; however, it develops rapidly and is potentially life-threatening without timely diagnosis and treatment. Since PD‑1 inhibitors are widely used in cancer treatment, complications such as type 1 diabetes mellitus should attract medical attention. During treatment, specialists should help patients better recognize the symptoms of hyperglycemia or diabetic ketoacidosis, which requires careful observation, regular monitoring of blood glucose levels, rapid detection and correct diagnosis and treatment of diabetes mellitus. 

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The authors declare that there are no conflicts of interest present.