Immunological Characteristics of Colitis Associated with Anti-CTLA-4 Antibody Therapy

ABSTRACT

Anti-CTL4-A therapy is associated with development of colitis. We characterized ipilimumab-associated colitis in nine melanoma patients (6 male, mean age: 55.3-yrs). Median value for diarrhea grade was 2, number of ipilimumab doses 2, and interval since last administration 3-wks. Endoscopic characteristics resembled inflammatory bowel disease and histology revealed predominance of plasmacytes or CD4+ T-cells. We observed significant upregulation of Th1 and Th17 effector pathways (>10-fold increase for IFN-γmRNA, >5-fold for IL-17A, p < 0.01 vs. controls). Significant elevation of FoxP3 was also detected. In conclusion, ipilimumab administration results in elevations of effector lymphocytes and pro-inflammatory mediators in the gut lamina propria.

KEYWORDS:

• Immunology/immunobiology
• Monoclonal antibodies
• Late effects of therapy
• Ipilimumab
• Colitis

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.