{"id":17064,"date":"2021-03-30T10:11:42","date_gmt":"2021-03-30T08:11:42","guid":{"rendered":"https:\/\/idibell.cat\/?p=17064"},"modified":"2021-03-30T10:12:12","modified_gmt":"2021-03-30T08:12:12","slug":"defineixen-les-caracteristiques-cliniques-de-les-complicacions-cerebrals-causades-per-immunoterapies-oncologiques-que-en-determinen-levolucio","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2021\/03\/defineixen-les-caracteristiques-cliniques-de-les-complicacions-cerebrals-causades-per-immunoterapies-oncologiques-que-en-determinen-levolucio\/","title":{"rendered":"Defineixen les caracter\u00edstiques cl\u00edniques de les complicacions cerebrals causades per immunoter\u00e0pies oncol\u00f2giques que en determinen l&#8217;evoluci\u00f3"},"content":{"rendered":"<p>El sistema immunitari t\u00e9 punts de control end\u00f2gens que inhibeixen la resposta immunit\u00e0ria per evitar que aquesta sigui excessiva i ens acabi danyant. Actualment, m\u00faltiples <strong>immunoter\u00e0pies<\/strong> contra el c\u00e0ncer es dirigeixen contra aquests punts de control. La finalitat \u00e9s bloquejar aquesta retroalimentaci\u00f3 negativa per permetre i afavorir que el sistema immunitari propi del pacient ataqui les c\u00e8l\u00b7lules tumorals.<\/p>\n<p>L&#8217;aparici\u00f3 d&#8217;aquests inhibidors dels punts de control immunol\u00f2gic ha obligat els onc\u00f2legs a bregar amb nous efectes adversos. Tot i presentar-ne menys que les ter\u00e0pies m\u00e9s cl\u00e0ssiques, s&#8217;ha reportat un ampli ventall de repercussions neurol\u00f2giques en el 2-6% dels pacients, amena\u00e7ant la vida en alguns casos. Entre aquestes destaca la <strong>inflamaci\u00f3 del cervell<\/strong>, o encefalitis, les caracter\u00edstiques cl\u00edniques de la qual s\u00f3n heterog\u00e8nies i no estan sistematitzades, a m\u00e9s, els factors de risc,\u00a0 pron\u00f2stic i efic\u00e0cia del tractament segueixen essent desconeguts fins ara.<\/p>\n<p>El grup de recerca de <a href=\"https:\/\/idibell.cat\/recerca\/area-de-cancer\/programa-de-mecanismes-mol%c2%b7leculars-i-terapia-experimental-en-oncologia-oncobell\/neuro-oncologia\/\">Neuro-Oncologia<\/a>, liderat pel <strong>Dr. Jordi Bruna<\/strong>, cap de grup de l\u2019IDIBELL i coordinador de la Unitat Funcional de Neuro-Oncologia HUB-ICO, juntament amb el <a href=\"https:\/\/idibell.cat\/recerca\/area-de-cancer\/programa-de-mecanismes-molleculars-i-terapia-experimental-en-oncologia-oncobell\/recerca-clinica-en-tumors-solids-crest\/\">CREST<\/a> (Clinical Research in Solid Tumors) ha caracteritzat aquesta complicaci\u00f3 amb l\u2019an\u00e0lisis dels seus propis casos i una revisi\u00f3 sistematitzada dels publicats en la literatura m\u00e8dica. L&#8217;estudi conclou que aquesta inflamaci\u00f3 del cervell es pot manifestar de dues maneres cadascuna amb un pron\u00f2stic concret.<\/p>\n<p>Un primer grup de pacients presenta despr\u00e9s del tractament una inflamaci\u00f3 difusa del cervell i les meninges que es tradueix en mal de cap, febre i impediments en el llenguatge, aquests pacients solen tenir un pron\u00f2stic favorable. No obstant, hi ha persones que desenvolupen s\u00edndromes m\u00e9s agressives focalitzades en regions concretes del cervell. En aquests casos la pres\u00e8ncia o no d&#8217;autoanticossos, que reconeguin prote\u00efnes pr\u00f2pies cerebrals, \u00e9s determinant per establir el pron\u00f2stic.<\/p>\n<p>La pres\u00e8ncia d&#8217;<strong>autoanticossos<\/strong> contra estructures cerebrals, com efecte colateral de la resposta immunit\u00e0ria del pacient contra el c\u00e0ncer, ja sigui indu\u00efda pels nous tractaments d\u2019immunoter\u00e0pia o, presents de forma subcl\u00ednica abans d\u2019iniciar-lo i potenciats en el moment d\u2019administrar-lo, s\u2019associen\u00a0 amb un pron\u00f2stic molt desfavorable en aquesta complicaci\u00f3.<\/p>\n<p>En resum, l&#8217;estudi publicat a la revista <a href=\"https:\/\/jamanetwork.com\/journals\/jamaneurology\/article-abstract\/2777621\"><em>JAMA Neurology<\/em><\/a> indica que el pron\u00f2stic de l&#8217;encefalitis causada pel tractament amb inhibidors dels punts de control immunol\u00f2gic ve determinat per dues manifestacions cl\u00edniques, combinat amb la pres\u00e8ncia d&#8217;autoanticossos en el l\u00edquid cefalorraquidi. Aquestes troballes poden ajudar a fer un diagn\u00f2stic preco\u00e7 i millorar el maneig dels pacients que presenten efectes secundaris de la immunoter\u00e0pia oncol\u00f2gica.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em>L\u2019Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l&#8217;Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l&#8217;Institut Catal\u00e0 de la Salut, l&#8217;Institut Catal\u00e0 d&#8217;Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/em><\/p>\n<p><em>L\u2019IDIBELL \u00e9s membre del Campus d&#8217;Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L&#8217;any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>L&#8217;estudi descriu dues s\u00edndromes, que combinen manifestacions cl\u00edniques i perfils del l\u00edquid cefalorraquidi diferencials, que determinen un diferent pron\u00f2stic en els pacients.<\/p>\n","protected":false},"author":8,"featured_media":17082,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[332,362,454],"tags":[],"class_list":["post-17064","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cancer","category-neuro-oncologia","category-p-depidemiologia-salut-publica-prevencio-del-cancer-i-cures-palliatives"],"publishpress_future_action":{"enabled":false,"date":"2024-12-25 11:49:00","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/17064","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=17064"}],"version-history":[{"count":0,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/17064\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/17082"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=17064"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=17064"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=17064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}