Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience
Cutaneous immune-related adverse events are frequently associated with immune checkpoint inhibitors (ICIs) administration in cancer patients. In fact, these monoclonal antibodies bind the cytotoxic T-lymphocyte antigen-4 and programmed cell death-1/ligand 1 leading to a non-specific activation of th...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1208418/full |
| _version_ | 1827897151395463168 |
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| author | Martina Merli Martina Accorinti Maurizio Romagnuolo Maurizio Romagnuolo Angelo Marzano Angelo Marzano Giovanni Di Zenzo Francesco Moro Emiliano Antiga Roberto Maglie Emanuele Cozzani Emanuele Cozzani Aurora Parodi Aurora Parodi Giulia Gasparini Giulia Gasparini Pietro Sollena Clara De Simone Clara De Simone Marzia Caproni Luigi Pisano Davide Fattore Riccardo Balestri Paolo Sena Pamela Vezzoli Miriam Teoli Marco Ardigò Camilla Vassallo Andrea Michelerio Andrea Michelerio Rosanna Rita Satta Emi Dika Emi Dika Barbara Melotti Simone Ribero Pietro Quaglino |
| author_facet | Martina Merli Martina Accorinti Maurizio Romagnuolo Maurizio Romagnuolo Angelo Marzano Angelo Marzano Giovanni Di Zenzo Francesco Moro Emiliano Antiga Roberto Maglie Emanuele Cozzani Emanuele Cozzani Aurora Parodi Aurora Parodi Giulia Gasparini Giulia Gasparini Pietro Sollena Clara De Simone Clara De Simone Marzia Caproni Luigi Pisano Davide Fattore Riccardo Balestri Paolo Sena Pamela Vezzoli Miriam Teoli Marco Ardigò Camilla Vassallo Andrea Michelerio Andrea Michelerio Rosanna Rita Satta Emi Dika Emi Dika Barbara Melotti Simone Ribero Pietro Quaglino |
| author_sort | Martina Merli |
| collection | DOAJ |
| description | Cutaneous immune-related adverse events are frequently associated with immune checkpoint inhibitors (ICIs) administration in cancer patients. In fact, these monoclonal antibodies bind the cytotoxic T-lymphocyte antigen-4 and programmed cell death-1/ligand 1 leading to a non-specific activation of the immune system against both tumoral cells and self-antigens. The skin is the most frequently affected organ system appearing involved especially by inflammatory manifestations such as maculopapular, lichenoid, psoriatic, and eczematous eruptions. Although less common, ICI-induced autoimmune blistering diseases have also been reported, with an estimated overall incidence of less than 5%. Bullous pemphigoid-like eruption is the predominant phenotype, while lichen planus pemphigoides, pemphigus vulgaris, and mucous membrane pemphigoid have been described anecdotally. Overall, they have a wide range of clinical presentations and often overlap with each other leading to a delayed diagnosis. Achieving adequate control of skin toxicity in these cases often requires immunosuppressive systemic therapies and/or interruption of ICI treatment, presenting a therapeutic challenge in the context of cancer management. In this study, we present a case series from Italy based on a multicenter, retrospective, observational study, which included 45 patients treated with ICIs who developed ICI-induced bullous pemphigoid. In addition, we performed a comprehensive review to identify the cases reported in the literature on ICI-induced autoimmune bullous diseases. Several theories seeking their underlying pathogenesis have been reported and this work aims to better understand what is known so far on this issue. |
| first_indexed | 2024-03-12T22:45:06Z |
| format | Article |
| id | doaj.art-54cab3571bda4d5c925013a4dc3c5c86 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T22:45:06Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-54cab3571bda4d5c925013a4dc3c5c862023-07-21T07:54:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-07-011010.3389/fmed.2023.12084181208418Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experienceMartina Merli0Martina Accorinti1Maurizio Romagnuolo2Maurizio Romagnuolo3Angelo Marzano4Angelo Marzano5Giovanni Di Zenzo6Francesco Moro7Emiliano Antiga8Roberto Maglie9Emanuele Cozzani10Emanuele Cozzani11Aurora Parodi12Aurora Parodi13Giulia Gasparini14Giulia Gasparini15Pietro Sollena16Clara De Simone17Clara De Simone18Marzia Caproni19Luigi Pisano20Davide Fattore21Riccardo Balestri22Paolo Sena23Pamela Vezzoli24Miriam Teoli25Marco Ardigò26Camilla Vassallo27Andrea Michelerio28Andrea Michelerio29Rosanna Rita Satta30Emi Dika31Emi Dika32Barbara Melotti33Simone Ribero34Pietro Quaglino35Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyDermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyDermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, ItalyDermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, ItalyLaboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, ItalyLaboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, ItalySection of Dermatology, Department of Health Sciences, University of Florence, Florence, ItalySection of Dermatology, Department of Health Sciences, University of Florence, Florence, ItalySection of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, ItalyDermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, ItalySection of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, ItalyDermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, ItalySection of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, ItalyDermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, ItalyDermatology Unit, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDermatology Unit, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, ItalyDermatology Unit, University Department of Medicine and Translational Surgery, Università Cattolica Del Sacro Cuore, Rome, Italy0Immunopathology and Rare Skin Diseases Unit, Section of Dermatology, Department of Health Sciences, Azienda Unità Sanitaria Locale Toscana Centro, University of Florence, Florence, Italy1Section of Dermatology, Department of Health Sciences, Azienda Unità Sanitaria Locale Toscana Centro, University of Florence, Florence, Italy2Section of Dermatology, Department of Clinical Medicine and Surgery, Università Degli Studi di Napoli Federico II, Naples, Italy3Division of Dermatology, Outpatient Consultation for Rare Diseases, APSS, Trento, Italy4Dermatology Unit ASST-Papa Giovanni XXIII, Bergamo, Italy4Dermatology Unit ASST-Papa Giovanni XXIII, Bergamo, Italy5Porphyria and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy5Porphyria and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy6Dermatology Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy7Dermatology Unit, Ospedale Cardinal Massaia, Asti, Italy8Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy9Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy0Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy1Unit of Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy2Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, ItalyDermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyDermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyCutaneous immune-related adverse events are frequently associated with immune checkpoint inhibitors (ICIs) administration in cancer patients. In fact, these monoclonal antibodies bind the cytotoxic T-lymphocyte antigen-4 and programmed cell death-1/ligand 1 leading to a non-specific activation of the immune system against both tumoral cells and self-antigens. The skin is the most frequently affected organ system appearing involved especially by inflammatory manifestations such as maculopapular, lichenoid, psoriatic, and eczematous eruptions. Although less common, ICI-induced autoimmune blistering diseases have also been reported, with an estimated overall incidence of less than 5%. Bullous pemphigoid-like eruption is the predominant phenotype, while lichen planus pemphigoides, pemphigus vulgaris, and mucous membrane pemphigoid have been described anecdotally. Overall, they have a wide range of clinical presentations and often overlap with each other leading to a delayed diagnosis. Achieving adequate control of skin toxicity in these cases often requires immunosuppressive systemic therapies and/or interruption of ICI treatment, presenting a therapeutic challenge in the context of cancer management. In this study, we present a case series from Italy based on a multicenter, retrospective, observational study, which included 45 patients treated with ICIs who developed ICI-induced bullous pemphigoid. In addition, we performed a comprehensive review to identify the cases reported in the literature on ICI-induced autoimmune bullous diseases. Several theories seeking their underlying pathogenesis have been reported and this work aims to better understand what is known so far on this issue.https://www.frontiersin.org/articles/10.3389/fmed.2023.1208418/fullimmunotherapyanti PD-1anti PD-L1cutaneous irAEbullous pemphigoidlichen planus pemphigoides |
| spellingShingle | Martina Merli Martina Accorinti Maurizio Romagnuolo Maurizio Romagnuolo Angelo Marzano Angelo Marzano Giovanni Di Zenzo Francesco Moro Emiliano Antiga Roberto Maglie Emanuele Cozzani Emanuele Cozzani Aurora Parodi Aurora Parodi Giulia Gasparini Giulia Gasparini Pietro Sollena Clara De Simone Clara De Simone Marzia Caproni Luigi Pisano Davide Fattore Riccardo Balestri Paolo Sena Pamela Vezzoli Miriam Teoli Marco Ardigò Camilla Vassallo Andrea Michelerio Andrea Michelerio Rosanna Rita Satta Emi Dika Emi Dika Barbara Melotti Simone Ribero Pietro Quaglino Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience Frontiers in Medicine immunotherapy anti PD-1 anti PD-L1 cutaneous irAE bullous pemphigoid lichen planus pemphigoides |
| title | Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience |
| title_full | Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience |
| title_fullStr | Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience |
| title_full_unstemmed | Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience |
| title_short | Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience |
| title_sort | autoimmune bullous dermatoses in cancer patients treated by immunotherapy a literature review and italian multicentric experience |
| topic | immunotherapy anti PD-1 anti PD-L1 cutaneous irAE bullous pemphigoid lichen planus pemphigoides |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1208418/full |
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