Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists
Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death protein (PD-1), and its ligand PDL-1, are finding increasing application in the treatment of malignant neoplasms. The widespread clinical use of these drugs, however, resulted in...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/12/2/395 |
| _version_ | 1797481228105940992 |
|---|---|
| author | Rachele Del Sordo Umberto Volta Vassilios Lougaris Paola Parente Angelo Sidoni Mattia Facchetti Gabrio Bassotti Illuminato Carosi Celeste Clemente Vincenzo Villanacci |
| author_facet | Rachele Del Sordo Umberto Volta Vassilios Lougaris Paola Parente Angelo Sidoni Mattia Facchetti Gabrio Bassotti Illuminato Carosi Celeste Clemente Vincenzo Villanacci |
| author_sort | Rachele Del Sordo |
| collection | DOAJ |
| description | Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death protein (PD-1), and its ligand PDL-1, are finding increasing application in the treatment of malignant neoplasms. The widespread clinical use of these drugs, however, resulted in the discovery of side effects. The occurrence of celiac disease (CD) after ICIs therapy has been reported in the literature, but its incidence remains unknown and the role of ICIs in its onset is not yet clear. In this review, we examine the published data on this topic in order to better understand and define this entity from a histological point of view. We performed an electronic literature search to identify original reports in which CD or pathological CD-like conditions were documented histologically in patients treated with ICIs. We identified ten papers. A total of twenty-five patients were included in these publications, eleven of them receiving a serologic and histological diagnosis of CD, and four a histological diagnosis of CD-like conditions, in which pathogenesis appears to be multifactorial. ICIs can cause a CD-like enteropathy and biopsies with clinical integration are crucial to diagnose this condition. CD rarely has been observed during treatment with ICIs and its morphological aspects are similar to ICIs-CD enteropathy. Moreover, the onset of ICIs-CD may have a distinct immune mechanism compared to classical CD. Thus, the pathologists must make a histological diagnosis of CD with caution and only in adequate clinical and serological context. |
| first_indexed | 2024-03-09T22:11:30Z |
| format | Article |
| id | doaj.art-8cc88d89eb06468b99f6d7cc23c7c9a1 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T22:11:30Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-8cc88d89eb06468b99f6d7cc23c7c9a12023-11-23T19:31:20ZengMDPI AGDiagnostics2075-44182022-02-0112239510.3390/diagnostics12020395Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for PathologistsRachele Del Sordo0Umberto Volta1Vassilios Lougaris2Paola Parente3Angelo Sidoni4Mattia Facchetti5Gabrio Bassotti6Illuminato Carosi7Celeste Clemente8Vincenzo Villanacci9Department of Medicine and Surgery, Section of Anatomic Pathology and Histology, Medical School, University of Perugia, 06132 Perugia, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, ItalyPediatrics Clinic, Department of Clinical and Experimental Sciences, University of Brescia and Children’s Hospital, ASST-Spedali Civili, 25123 Brescia, ItalyPathology Unit, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, ItalyDepartment of Medicine and Surgery, Section of Anatomic Pathology and Histology, Medical School, University of Perugia, 06132 Perugia, ItalyInstitute of Pathology, ASST-Spedali Civili Brescia, 25123 Brescia, ItalyGastroenterology & Hepatology Section, Department of Medicine and Surgery, University of Perugia, 06132 Perugia, ItalyPathology Unit, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, ItalyPathology Unit, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, ItalyInstitute of Pathology, ASST-Spedali Civili Brescia, 25123 Brescia, ItalyImmune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), programmed cell death protein (PD-1), and its ligand PDL-1, are finding increasing application in the treatment of malignant neoplasms. The widespread clinical use of these drugs, however, resulted in the discovery of side effects. The occurrence of celiac disease (CD) after ICIs therapy has been reported in the literature, but its incidence remains unknown and the role of ICIs in its onset is not yet clear. In this review, we examine the published data on this topic in order to better understand and define this entity from a histological point of view. We performed an electronic literature search to identify original reports in which CD or pathological CD-like conditions were documented histologically in patients treated with ICIs. We identified ten papers. A total of twenty-five patients were included in these publications, eleven of them receiving a serologic and histological diagnosis of CD, and four a histological diagnosis of CD-like conditions, in which pathogenesis appears to be multifactorial. ICIs can cause a CD-like enteropathy and biopsies with clinical integration are crucial to diagnose this condition. CD rarely has been observed during treatment with ICIs and its morphological aspects are similar to ICIs-CD enteropathy. Moreover, the onset of ICIs-CD may have a distinct immune mechanism compared to classical CD. Thus, the pathologists must make a histological diagnosis of CD with caution and only in adequate clinical and serological context.https://www.mdpi.com/2075-4418/12/2/395immune checkpoint inhibitorsceliac diseaseCD-like conditionsenteropathyduodenitisPD-1 |
| spellingShingle | Rachele Del Sordo Umberto Volta Vassilios Lougaris Paola Parente Angelo Sidoni Mattia Facchetti Gabrio Bassotti Illuminato Carosi Celeste Clemente Vincenzo Villanacci Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists Diagnostics immune checkpoint inhibitors celiac disease CD-like conditions enteropathy duodenitis PD-1 |
| title | Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists |
| title_full | Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists |
| title_fullStr | Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists |
| title_full_unstemmed | Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists |
| title_short | Histological Features of Celiac-Disease-like Conditions Related to Immune Checkpoint Inhibitors Therapy: A Signal to Keep in Mind for Pathologists |
| title_sort | histological features of celiac disease like conditions related to immune checkpoint inhibitors therapy a signal to keep in mind for pathologists |
| topic | immune checkpoint inhibitors celiac disease CD-like conditions enteropathy duodenitis PD-1 |
| url | https://www.mdpi.com/2075-4418/12/2/395 |
| work_keys_str_mv | AT racheledelsordo histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT umbertovolta histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT vassilioslougaris histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT paolaparente histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT angelosidoni histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT mattiafacchetti histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT gabriobassotti histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT illuminatocarosi histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT celesteclemente histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists AT vincenzovillanacci histologicalfeaturesofceliacdiseaselikeconditionsrelatedtoimmunecheckpointinhibitorstherapyasignaltokeepinmindforpathologists |