Immune Checkpoint Inhibitor-Induced Diabetes Mellitus: Potential Role of T Cells in the Underlying Mechanism

Int J Mol Sci. 2021 Feb 20;22(4):2093. doi: 10.3390/ijms22042093.

Abstract

Immunotherapy is now a recognized treatment option for several types of cancer. However, some cancer patients treated with immune checkpoint inhibitors (ICIs) are subject to immune-related adverse events, including induced diabetes mellitus. The exact role and molecular/genetic action of ICIs in diabetes are still not well understood. Elucidating the underlying mechanisms in a proper fashion would allow better refining of biomarkers that would help diagnose patients at risk of altered immune system homeostasis, but would also hold the potential of new therapeutic options for diabetes. In the present narrative review, we propose to discuss the case of autoimmune diabetes following treatment with ICIs and the role of ICIs in the pathophysiology of diabetes. We also present some scarce available data on interesting potential immune therapies for diabetes.

Keywords: CTLA-4; PD-1; PD-L1; autoimmune diabetes; immune checkpoint inhibitor-induced diabetes mellitus; immune checkpoint inhibitors; immune-related adverse events; type I diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Animals
  • B7-H1 Antigen / metabolism
  • Diabetes Mellitus / chemically induced*
  • Diabetes Mellitus / immunology*
  • Diabetes Mellitus / pathology
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immunotherapy
  • Programmed Cell Death 1 Receptor / metabolism
  • T-Lymphocytes / immunology*

Substances

  • B7-H1 Antigen
  • Immune Checkpoint Inhibitors
  • Programmed Cell Death 1 Receptor