Primary mechanisms of ICIs-associated cardiotoxicity

The primary mechanisms of ICIs-associated cardiotoxicity. Surface MHCs and co-inhibitory molecules including B7 or PD-1 ligands on tumor cells as well as APC (e.g., dendritic cells) attach to activated T cells through the TCR, PD-1, and CTLA-4 receptors. Apoptosis of tumor cells induced by ICI is mediated by the activation of T cells. The PD-L1 ligands on cardiomyocytes are hypothesized to be responsible for downregulating this pathway in the myocardium. Myocarditis and atherosclerosis are the primary outcomes of blocking this regulatory pathway. APC, antigen-presenting cell; CTLA-4, cytotoxic T lymphocyte-associated protein-4; MHC, major histocompatibility complex; PD-1, programmed cell death 1; PD-L1, programmed death ligand 1; TCR, T-cell receptor. Figure 2 was modified from Servier Medical Art (http://smart.servier.com/ (accessed on 30 March 2023)), licensed under a Creative Common Attribution 3.0 Generic License (https://creativecommons.org/licenses/by/3.0/ (accessed on 30 March 2023))

Publication

Cardiovascular Complications of Pan-Cancer Therapies: The Need for Cardio-Oncology (2023) Mengjia Chen, et al. Cancers (Basel). 2023 Jun;15(11). Figure: F2. Homo sapiens

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