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Anti–PD-1 and Anti–PDL-1 Monoclonal Antibodies Causing Type 1 Diabetes

Mahnaz Mellati, Keith D. Eaton,Barbara Brooks‐Worrell, William Hagopian, Renato Martins,Jerry P. Palmer,Irl B. Hirsch

Diabetes care(2015)

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Abstract
Checkpoint inhibitors have an anticancer effect by removing a negative regulatory signal for T-cell activation from the tumor microenvironment (Fig. 1). They include cytotoxic T-cell–associated antigen (CTLA-4), programmed cell death protein-1 (PD-1), and programmed cell death ligand-1 (PDL-1) antibodies and are now being widely used for the treatment of different types of cancer. From the initial phases of checkpoint inhibitor use, there has been concern about the potential for the development of autoimmune disease as a result of T-cell activation. Subsequently, multiple autoimmune diseases were indeed observed as a result of these medications (1). Although both PD-1 and PDL-1 antibodies can precipitate type 1 diabetes in the nonobese diabetic mice model (2), only very recent reports have noted type 1 diabetes after PD-1 antibody use in humans (3,4). Here, we describe two older adults without diabetes receiving agents inhibiting the PD-1 pathway for resistant cancers who developed acute …
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Key words
PD-1 and PD-L1,Type 1 Diabetes,Immune Checkpoint Blockade
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