The role of immune checkpoint inhibitors in the development and treatment of infectious processes

Abstract

The incidence and prevalence of oncological diseases, which are in second place in terms of the frequency of causes of death, is steadily increasing among the population of the Russian Federation. Advances in translational medicine, including immunotherapy, have revolutionized cancer treatment strategies. A special breakthrough has been achieved in two areas of immunotherapy that have modernized cancer treatment: chimeric T-cell receptors and antibodies known as immune checkpoint inhibitors (ICTs) blocking cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed cell death protein-1 (PD-1) and ligand programmed cell death receptor (PD-L1). ICTs enhance the adaptive immune response of the tumor and can cause adverse effects as a result of hyperactivation of T cells, which often leads to the emergence of an opportunistic infection. In addition, immunosuppressive drugs, which are often prescribed to mitigate the side effects associated with ICT, are also a risk factor for infection. The purpose of the review is to analyze the literature on possible relationships between ICT inhibitors and the risk of infection, as well as to consider the possible benefits of ICT inhibitors as a treatment for various types of infections, including viral, parasitic and fungal, as well as sepsis. Although ICT inhibitors have demonstrated the ability to significantly prolong the life expectancy of patients with advanced cancer, they often lead to adverse events, which often requires treatment with immunosuppressive drugs, including corticosteroids, anti-TNF and other biological agents. The overall effect of ICT inhibitors on human infections remains poorly understood. Further research is needed to understand the basic mechanisms of the immunological effects of ICT inhibitors on various types of infections, which in some cases may be beneficial.