453
HLAVNÍ42522001005185134178232252
TÉMA69222001003981147194
Imunitně42533001001676114151166193232268
zprostředkovaný7093300100306993131161188213248287321359395430468504
diabetes12293300100375287125161188223252
mellitus149733001006095111126141168206235
indukovaný17483300100155291128163200236271309345
checkpoint210933001003067103134168207246262299326
inhibitory:24513300100155290105143159185224248287304
kazuistiky277133001003469101139154183210226260299
a3086330010034
klinický31363300100335065103118148182221
přehled33733300100376197134150185224
pro361333001003762100
internisty37293300100155279114138177192221248287
49818822001004081123
|351220010018
VNITŘNÍ4268040010746106127172220280301
LÉKAŘSTVÍ748804001074185130188236280325378400
/11948040010731
Vnitř1270804001074693112140166
Lék.1456804001074083122140
2025;71(8):498-5011615804001074487129173186227268286329351366409451495523566609649
/23098040010732
www.casopisvnitrnilekarstvi.cz442680400107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2025.09042544001003865941331631802022236484400100418310274944001001554791171398904400100287389124167204247293316355396414432470516552587605649691737
Imunitně425980027565251379507573663792910
zprostředkovaný14129800275100228321447551639733852981110812311352147216001726
diabetes32159800275124189311439558648766870
mellitus41629800275182300366432498588716821
indukovaný425124002756018831744557169481693610641190
checkpoint1692124002759622434344457170282789210201110
inhibitory:2879124002756018831638251057666579088210151085
kazuistiky4041124002751212423474745396447327999251059
a42515000275116
klinický58815000275122189255383449549677810
přehled147515000275123216335464529648777
pro232915000275124216342
internisty274815000275611882783954896156817858741005
Martina4251890013793152194236267332390
Tuháčková,8371890013761118182240290350413469527557
Jan14161890013745103168
Brož16061890013767109172224
Interní425204001332687122176211272297
klinika,746204001335178103163188239293315
2.1085204001335679
LF11872040013352105
UK13152040013372131
a14692040013353
FN15452040013354124
Motol,16922040013389149185244270292
Praha2007204001335993146207259
Checkpoint4252550012159116168216264325383408465499
inhibitory955255001212481139164222248283339373426
(immune1412255001212953138224281338391
checkpoint18342550012146103155203251312370395452486
inhibitor2351255001212481139164222248282339373
–27552550012151
ICI)2837255001212585110139
představují3007255001215892144203244280331380437463488
klíčový352625500121477499145201250302
pokrok38602550012157115165201257306
v41982550012148
léčbě4278255001212376123182235
řady4544255001213384142192
solidních4767255001214098123148207264289335392
nádorů,51912550012156106165222257314336
avšak425269001214896136186234
jejich686269001212476101125171227
použití9402690012157114170214239273297
je1264269001212576
spojeno1368269001213997154178230286342
s17382690012140
rizikem1805269001213358101126173223308
vzniku2141269001214894150174222278
imunitně24472690012123107163219244278334385
podmíněných28602690012157114172256280337388445491536592
nežádoucích34802690012155107151202259315372418442487543
účinků40512690012155101125181229285
(irAEs).436326900121295286144193235261280
Mezi46712690012180132176201
vzácné,4899269001214894145191247299320
ale5246269001214873124
klinicky539826900121477397425283001215580125173224
významné6762830012148100146202251336392443
irAEs1146283001212457115165206
patří13792830012157107140174198
inzulin-dependentní1604283001212379123180204228284317377429487539595653704761794851875
diabetes2506283001215680129187239273324364
mellitus28972830012183135160184208242298338
(ICI-DM),3262283001212852112136169239320348367
který3656283001214784134168220
fenotypově3902283001213081138194228278337394442492
odpovídá44212830012155113171228276301358407
diabetu4855283001215681129187239273329
1.5211283001215269
typu.5306283001213484143200221
Tento425297001215095151185240
článek689297001214569118174225274
prezentuje987297001215791141186237293327383407459
dvě14702970012156106156
kazuistiky1650297001214797141197222262297321368420
pacientů,20942970012157106152176227284317373395
u25132970012155
nichž2593297001215579125181225
došlo28422970012156113153177233
k31002970012146
rozvoji3171297001213288131183238262287
ICI-DM3482297001212483107141210292
v37982970012148
průběhu3870297001215791147205257313369
terapie4263297001213384117167225249300
anti-PD-145882970012148104138162194250317352398
protilátkami5010297001215791146180204229278311359409493517
(nivolumab,425311001212882106155210235291375424482503
pembrolizumab).9553110012156109193251285340365389433489574623680707727
První1709311001215386138195219
případ1955311001215791115173223280
ilustruje2262311001212448104144179212269293345
akutní2634311001214896152186243267
nástup29283110012155104144179235293
ICI-DM3248311001212483107141210292
ve3567311001214898
formě3692311001212985119204255
diabetické3974311001215681130187239274298343391441
ketoacidózy4442311001214797131186236282306363419462513
s49823110012140
pozitivními50493110012157114156181215239288346370454478
autoprotilátkami4253250012148104138193251285341374398423472505553603687711
a11663250012148
souběžnou1243325001214096152210262306363419475
autoimunitní17473250012149104138193218302358414438472529553
hepatitidou.23293250012156107165215248272306330388444500522
Druhý28813250012166101157213260
pacient31703250012157107153177228284318
s35173250012140
preexistujícím3586325001215791142194242267307342398422447492516600
diabetem4216325001215680129187239273324408
2.4654325001215173
typu4757325001213383142199
byl49853250012157104129
původně51443250012157113162217276332383
diagnostikován425339001215680128185241296336371394441496543592648
s10933390012139
dekompenzací11523390012156106154208292350401457501551597620
již179233900121244891
známého1903339001214298147230282338393
onemocnění,23163390012155111162246301347403454510534555
až2891339001214892
dynamický30023390012156104161210293317362409460
pokles34823390012156113161186237277
C-peptidu3779339001215783142193251285308365421
potvrdil42193390012157113147198232288312336
autoimunitní45753390012148103136191215299354410433467523547
destrukci51413390012156107147182215271318362386
β-buněk.425353001215588146201256307354377
Diskuze821353001216690129175231274324
shrnuje1164353001213994127182237261311
současné1494353001213995150195243283338388
poznatky19013530012156112154209257290337387
o23073530012154
patogenezi,23803530012156105138192248298354404448472492
klinickém289135300121477295150174219265314397
průběhu3307353001215689145201252307362
a36883530012148
managementu37553530012182130185233289339422473528561616
ICI-DM,4390353001212382105138206286308
zdůrazňuje4717353001214399153186235278333388412462
význam5198353001214898143199247330
sledování425367001214064115173230278327383408
C-peptidu856367001215884143195253287311369424
a13043670012148
glykemie1375367001215680129177227312336387
v17853670012149
průběhu1857367001215791147204256313369
imunoterapie.22493670012123107163219276309360393443501525576598
Klíčová425384001235885110154210259310
slova:752384001234167124173223246
checkpoint1016384001214599149195241299354377432464
inhibitory,1498384001212378133156212235268322354404420
imunitně19363840012123106160215238270325375
podmíněné23293840012157112169252275330380435485
nežádoucí28313840012156106149198254309364409431
účinky,3280384001215599122177223273289
diabetes3586384001215780127183234267316355
mellitus39593840012183133157180202235290328
1.4305384001215167
typu,4390384001213382139194215
ICI-DM,4623384001212381104136205284306
imunoterapie,49473840012123106160215270302351384432488512561581
autoimunitní4253980012148103136190213296351407430463518541
toxicita.987398001213488133157201224257306327
Immune-mediated42542300150351362363053734364895906537227568218689311000
diabetes14634230015067102166235298346409464
mellitus19664230015099162197231266313381437
induced24414230015033102170239292355424
by29034230015067134
checkpoint30764230015052120184237305375442476544592
inhibitors:37064230015033101170204273307354421470525561
case43064230015052116172235
reports45794230015048111180247296345401
and50194230015063131200
clinical425437001505287122190224278342377
overview8404370015066131192242311345408500
for13784370015047114163
internists15804370015033101148211260328362418464520
Immune4254570012124107189244299349
checkpoint792457001214499149195241299354378432465
inhibitors1274457001212479134156213236269323355396
(ICIs)1687457001212951109132171196
represent1900457001213382139172221261311366398
a23164570012148
major23824570012183131154209241
advancement26414570012148105153201256300349432483538570
in3229457001212378
the3325457001213387138
treatment3480457001213366115163195278328384416
of3913457001215584
solid4015457001213994118141197
tumors,4230457001213387170225258298319
but45664570012157112145
their4729457001213387138161193
use4940457001215594144
carries5102457001214493125158181231270
the5390457001213388138
risk42547100121335695142
of592471001215584
immune-related7024710012123106189244299350383417467491539571621678
adverse14054710012148105153202235276326
events1756471001215198147203235276
(irAEs).205747100121295183140189229254273
Among23554710012161144200255311
the2692471001213388138
rare2856471001213281113163
but30454710012156112145
clinically321547100121456891146169214263286310357
significant3597471001214063119174197226253297346401434
irAEs4056471001212356113161202
is4283471001212362
insulin-dependent4371471001212378117172195218273306365415472523579635686741774
diabetes5170471001215680127184235268318357
mellitus4254850012183133156179202234289327
(ICI-DM),770485001212850108131163231310336355
which11424850012173128151195250
shares1409485001214094142174223262
features1688485001212979127159213245294333
with2039485001217396129183
type2240485001213282139189
124474850012151
diabetes.2515485001215679126182233266314353374
This29074850012149105128166
article3091485001214780115138182205254
presents3363485001215689138177227282314354
two37344850012133108162
case3913485001214593132182
reports4112485001213382138193226261301
of4431485001215483
patients45324850012156104136159209264296336
who48854850012173128183
developed50854850012156106153202225280336387443
ICI-DM425499001212482105138206287
during7394990012156111143167222278
anti-PD-110444990012148103136159191246311345390
therapy1461499001213388139171220277323
(nivolumab,1811499001212881104152206230285368416473492
pembrolizumab).23304990012157108192249282336360383426481564612669695713
The30704990012150106157
first325449900121295587128162
case3442499001214594133184
involved3652499001212479125179203252301358
acute4037499001214893148181230
onset42944990012155111150200234
of4554499001215584
ICI-DM4665499001212483105138207287
with4979499001217397130185
diabetic5191499001215780128184235269292337
ketoacidosis,425513001214796129183232277300356412451474513534
positive9845130012157113153175208232280329
autoantibodies,13395130012148102136190238294326349406461519542592631652
and20175130012148104160
concurrent2203513001214599154199254287320369425457
autoimmune26865130012148103136190214297380435490540
hepatitis.32525130012156106163212244267300323363384
The36625130012149106156
second3844513001213990136189245302
patient,41715130012157106138161212267300321
with4517513001217498131186
pre-existing4729513001215790139173225273296335369392448504
type5258513001213383141192
254765130012151
diabetes,425527001215680127184235269318357378
initially825527001212379102135158206229252300
presented1146527001215790140179230285318367424
with1592527001217497130186
hyperglycemia;17995270012156101159210243298322369413462546569617637
however,24575270012156111184233281330363379
a28575270012148
rapid2927527001213381138162218
decline31675270012156106152175198253304
in3492527001212479
C-peptide3593527001215883141192249282305362412
levels4027527001212373121170194233
later4282527001212371104153186
confirmed4490527001214498154183209241325376433
β-cell4944527001215689136185209233
autoimmune519852700121481031361902142974255410012183138193244
destruction.6905410012157107147181213268313349372427483504
The12155410012150106157
discussion1393541001215780119164219258297320375431
summarizes1845541001214094178261309341365408458497
current2364541001214499132165215270303
knowledge26885410012147104159232256306363420470
of3179541001215584
the3285541001213388139
pathogenesis,34455410012157106138193248305356411462501524563584
clinical405154100121446891146169214262286
course,4358541001214599154187227277297
and46775410012148103160
management48585410012184132187235291341425475531563
of5443541001215584
ICI-DM,425555001212482105138206287309
emphasizing7555550012150134190246294334356399423478534
the1310555001213388139
importance14705550012123107163219252288337392437486
of1977555001215584
monitoring20835550012183138194217250304337361416472
C-peptide2576555001215883141192249282305362412
and30105550012148103160
blood3191555001215781136192249
glucose3461555001215679134179233272322
during38055550012156111143167222278
immunotherapy.41045550012124107190245300355388443494526575632678694
Key4255720012358109158
words:6115720012375131167225267290
checkpoint9305720012145100151196243301357381436469
inhibitors,1427572001212379134157214238271325358398420
immune-related18755720012123107190245300351384418468492540573622680
adverse25835720012148105153203236276327
events,2938572001215098147203235276297
type3263572001213383141192
134845720012151
diabetes3563572001215780128185236269319358
mellitus,39505720012183134158181204237292332353
ICI-DM,4331572001212482105138207287309
immunotherapy,46695720012123106190245300355388443494527576632679695
autoimmune53925720012148103425586001213387111194277332387437
toxicity.884586001213387132156200223257306323
Úvod4256330013874137198262
V5656500010746
posledním633650001075099133152195246294312386
desetiletí1041650001074993127171199218236280308327
došlo1391650001074997130149197
v16116500010741
oblasti1674650001074898118158192221239
onkologické1936650001074897134182201250300318359396440
léčby2398650001071963104154193
k26146500010738
zásadnímu2674650001073679112154203425664001074967142190
posunu6416640010750100134182230278
díky946664001074968108152
zavedení1124664001073780120163214259307326
imunoterapie,1477664001071993141189238266309336378428448492507
zejména201066400107378099174218267308
tzv.2345664001072867111124
checkpoint2495664001074189134176214266315335383410
inhibitorů.425678001071968117136187207235283311360375
Tyto827678001074378110158
monoklonální10126780010775125174224263285334383425445493513
protilátky1552678001075078126154173193234262301345
blokují1924678001075171120160209228248
regulační2199678001072771122170190231273322341
molekuly25676780010775124145190229278297338
imunitního425692001071992140188206234283301351400
systému,844692001073374108137180254301317
jako118069200107195997145
jsou1344692001071952100149
CTLA-41512692001075196138193220266
(cytotoxic1797692001072462104135182209256294313353
T-lymphocyte–associated217069200107416484124199249297346387429460503550591624658706304763600107405999126169219
antigen3288636001074189116134183227276
4),358663600107446579
PD-136876360010745102132170
(programmed3879636001072474101148198225266340414458508
death-1)4409636001074993133160208237275293
a47246360010741
PD-L147876360010745102132174211
(programmed5020636001072474101148198224266339413457507
death-ligand3047650001075094135163212240261280330371420470
1),354465000107446276
čímž3647650001074159134171
umožňují38456500010749123172209258306325344
aktivaci4216650001074180111131172215256275
protinádorové4518650001075077125153172221262312361389437478522
imunitní5066650001071994142191210238288307
odpovědi.539965000107491003047664001075099139182232251267
Vedlejším3336664001074687137156200219251270343
nežádoucím3701664001074993130172221270318358377450
efektem4174664001074367111149180222296
je4492664001071963
však4577664001074175116154
i47546640010718
ztráta479566400107366794135162204
tolerance502166400107287494138165206254295337
vůči5381664001074089128146
vlastním3047678001074161101135164213231305
antigenům,3379678001074189116135184229277325398414
což3819678001074187123
může39696780010774121158201
vést4197678001074084118147
ke4370678001073982
vzniku4478678001074180129148186234
autoimunitních4739678001074189117164183257304353371400448467507555
reakcí5321678001072670110148188206
(1,304769200107246576
2).315069200107456881
Autoimunitní32596920010753101130178198272321370390418468487
nežádoucí3773692001074995133176226276325367386
účinky4186692001074990109158197241
mohou44546920010775125175224274
postihnout47556920010750101135165184233283332382410
prakticky5193692001075078121160191211252291335
MUDr.425740009562112164189200
Jan64374000952764107
Brož,76774000954165107139154
Ph.D.9397400095408297150163
Interní4257520095176084122146190207
klinika6497520095345369112129163201
FN86875200953787
Motol972752009563106131172190
a1180752009536
2.123475200953953
LF130475200953673
UK,139575200955090106
Praha151975200954063101144180
jan.broz@fnmotol.cz4257640095175396111157181223255313336380445489514555573588624658
Cit.43907400095466388103
zkr:45107400095336792108
Vnitř463574000954183100125149
Lék.480274000953674109125
2025;71(8):498-501494574000953977114154166203239256294315328367404444469508546582
Článek45267520095466399142182216
přijat47597520095456986103139164
redakcí:494075200952462107144178213230243
15.52017520095397386
9.530575200953951
2025537375200953978115155
Článek42977640095466399142182216
přijat45307640095456986103139164
po471176400954488
recenzích:48177640095246299137180214231267310323
30.51587640095397892
10.52687640095397488
2025537476400953977114154