The Analysis of Renal Infiltrating Cells in Acute Tubulointerstitial Nephritis Induced by Anti-PD-1 Antibodies: A Case Report and Review of the Literature

Intern Med. 2018 Nov 1;57(21):3135-3139. doi: 10.2169/internalmedicine.0444-17. Epub 2018 Jun 6.

Abstract

Nivolumab is an anti-programmed cell death-1 (PD-1) antibody that is utilized as an immune checkpoint inhibitor (ICI) for cancer therapy. We herein present the case of a 57-year-old man who developed acute kidney injury during treatment with nivolumab for lung cancer. A renal biopsy revealed acute tubulointerstitial nephritis. Immunohistochemical staining demonstrated marked infiltration of macrophages and T cells together with mild B cell infiltration. Of note, strong CD163+ M2 macrophage infiltration was observed. The cessation of nivolumab and high-dose prednisolone therapy improved the renal function of the patient. Further, we review the pertinent literature on renal-infiltrating cells in ICI-induced tubulointerstitial nephritis.

Keywords: M2 macrophage; acute tubulointerstitial nephritis; anti-PD-1 antibody; immune checkpoint inhibitor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / drug therapy
  • Acute Kidney Injury / immunology
  • Acute Kidney Injury / pathology
  • Antibodies / immunology*
  • Antigens, CD / immunology
  • Antigens, Differentiation, Myelomonocytic / immunology
  • Antineoplastic Agents, Immunological / adverse effects*
  • Antineoplastic Agents, Immunological / immunology*
  • B-Lymphocytes / immunology
  • B-Lymphocytes / pathology
  • B7-H1 Antigen / antagonists & inhibitors
  • B7-H1 Antigen / immunology
  • Humans
  • Immunologic Factors / therapeutic use
  • Kidney / immunology
  • Kidney / pathology*
  • Lung Neoplasms / drug therapy
  • Macrophages / immunology
  • Macrophages / pathology
  • Male
  • Middle Aged
  • Nephritis, Interstitial / chemically induced*
  • Nephritis, Interstitial / drug therapy
  • Nephritis, Interstitial / immunology
  • Nephritis, Interstitial / pathology*
  • Nivolumab / adverse effects*
  • Nivolumab / immunology*
  • Prednisolone / therapeutic use
  • Programmed Cell Death 1 Receptor
  • Receptors, Cell Surface / immunology
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology

Substances

  • Antibodies
  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • CD163 antigen
  • CD274 protein, human
  • Immunologic Factors
  • Programmed Cell Death 1 Receptor
  • Receptors, Cell Surface
  • Nivolumab
  • Prednisolone

Supplementary concepts

  • Acute Tubulointerstitial Nephritis