Parisa Keshtgar
1 
, Parisa Kaviani
2 , Payam Peymani
3 , Neda Kianpour
4 , Samin Karamian
5* 1 Rural Health Services Center, Mashhad, Iran
2 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
3 College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
4 Department of Biotechnology, Biohouse, Inland Norway University of Applied Sciences, Hamar, Hedmark, Norway
5 Emergency Department, Parsian Hospital, Shahrekord, Iran
Abstract
Immune checkpoint inhibitors (ICIs) constitute a class of drugs that stimulate the immune system to fight cancer cells. However, they can also induce immune-related adverse events (irAEs) in various organs, including the kidneys. One of the infrequent irAEs associated with ICIs is sarcoidosis, an inflammatory disease that can impact multiple organs, such as the lungs, skin, and lymph nodes. Sarcoidosis is characterized by the formation of granulomas, clusters of immune cells that can potentially harm tissues. In some cases, ICIs can trigger kidney sarcoidosis, leading to impaired renal function. The mechanism through which ICIs initiate sarcoidosis is believed to involve activating T cells and cytokines that foster inflammation.
Implication for health policy/practice/research/medical education:
The renal sarcoidosis-like reaction is a rare immune-related adverse event (irAE) associated with programmed cell death protein 1 (PD-1) inhibitors, immunotherapy drugs utilized to treat various cancers. PD-1 inhibitors block the PD-1 receptor on T cells, enabling them to attack cancer cells more effectively. However, this mechanism triggers the activation of the immune system, leading to inflammation in various organs, including the kidneys.
Please cite this paper as: Keshtgar P, Kaviani P, Peymani P, Kianpour N, Karamian S. Immune checkpoint inhibitor-associated sarcoidosis reaction. J Nephropathol. 2023;12(4):e21520. DOI: 10.34172/jnp.2023.21520.