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Current cancer therapies and their influence on glucose control

World Journal of Diabetes 2021年第7期12卷 1010-1025页

作者： Carly Yim Kerry Mansell Nassrein Hussein Terra Arnason Department of Medicine University of SaskatchewanSaskatoon S7N 0W8SaskatchewanCanada College of Pharmacy and Nutrition University of SaskatchewanSaskatoon S7N 5E5SaskatchewanCanada Department of Medicine Division of EndocrinologyUniversity of SaskatchewanSaskatoon S7N 0W8SaskatchewanCanada Departments of Anatomy and Cell Biology and Medicine Division of EndocrinologyUniversity of SaskatchewanSaskatoon S7N 0W8SaskatchewanCanada

This review focuses on the development of hyperglycemia arising from widely used cancer therapies spanning four drug *** groups of medications were selected due to their significant association with new onset hyperglycemia,or of potentially severe clinical consequences when *** classes include glucocorticoids that are frequently used in addition to chemotherapy treatments,and the antimetabolite class of 5-fluorouracil-related *** of these classes have been in use in cancer therapy since the *** considered are the phosphatidyl inositol-3-kinase(PI3K)/AKT/mammalian target of rapamycin(mTOR)-inhibitors that provide cancer response advantages by disrupting cell growth,proliferation and survival signaling pathways,and have been in clinical use as early as *** final class to be reviewed are the monoclonal antibodies selected to function as immune checkpoint inhibitors(ICIs).These were first used in 2011 for advanced melanoma and are rapidly becoming widely utilized in many solid *** each drug class,the literature has been reviewed to answer relevant questions about these medications related specifically to the characteristics of the hyperglycemia that develops with *** incidence of new glucose elevations in euglycemic individuals,as well as glycemic changes in those with established diabetes has been considered,as has the expected onset of hyperglycemia from their first *** comparison emphasizes that some classes exhibit very immediate impacts on glucose levels,whereas other classes can have lengthy delays of up to 1 year.A comparison of the spectrum of severity of hyperglycemic consequences stresses that the appearance of diabetic ketoacidosis is rare for all classes except for the *** are distinct differences in the reversibility of glucose elevations after treatment is stopped,as the mTOR inhibitors and ICI classes have persistent hyperglycemia long *** four highlighted drug categories differ in their

关键词： Cancer therapy Hyperglycemia adverse drug effects Immune checkpoint inhibitors mTOR inhibitors 5-fluorouracil analogs Glucocorticoids Diabetes mellitus

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Development of ulcerative colitis in a patient with multiple sclerosis following treatment with interferonβ 1a

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World Journal of Gastroenterology 2007年第26期13卷 3638-3640页

作者： Eckart Schott Friedemann Paul Jens T Wuerfel Frauke Zipp Birgit Rudolph Bertram Wiedenmann Daniel C Baumgart Department of Medicine Division of Gastroenterology and HepatologyCharité Medical SchoolHumboldt-University of BerlinGermany Cecilie-Vogt-Clinic for Molecular Neurology Charité Medical SchoolHumboldt-University of BerlinGermany Department of Pathology Charité Medical SchoolHumboldt-University of BerlinGermany

To alert clinicians to a potential novel adverse drug effect of interferonβ la, we herein report a patient with relapsing-remitting multiple sclerosis who developed ulcerative colitis following treatment with interferonβ la. Ulcerative colitis persisted despite discontinuation of interferonβ la treatment and switching the patient to glatiramer acetate. Tacrolimus （FK506）, 6-mercaptopurine, and prednisolone were required to induce remission. Both ulcerative colitis and multiple sclerosis were eventually well controlled using this regimen. Our report underscores that caution should be exercised when prescribing immunostimulatory agents in patients with inflammatory bowel disease （IBD） and challenges current efforts to stimulate innate immunity as a novel therapeutic concept for IBD.

关键词： Ulcerative colitis Interferonβ la Tacrolimus Innate immunity Multiple sclerosis adverse drug effects

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