Abstract
B细胞激活因子(B-cell activating factor, BAFF)作为B细胞的关键调节因子,参与多种自身免疫性疾病。炎症性肠病(inflammatory bowel disease, IBD)是一组病因尚不明确的慢性、反复发作的肠道炎症性疾病,近年来全球发病率呈上升趋势。多种因素引起的异常免疫反应与IBD发病密切相关,B细胞异常活化及自身抗体产生增加在溃疡性结肠炎的发病中已得到证实,而BAFF是否参与IBD发病机制尚不明确。该文就目前关于BAFF在IBD发病机制中的潜在作用以及在IBD中针对BAFF的靶向治疗研究进行综述,旨在为IBD靶向治疗提供思路。
Keywords: 炎症性肠病, B细胞激活因子, 靶向治疗
Abstract
B-cell activating factor (BAFF), a critical regulator of B cells, is involved in various autoimmune diseases. Inflammatory bowel disease (IBD) is a group of chronic and recurrent intestinal inflammatory disorders with unclear etiology, and its global incidence has been increasing in recent years. Abnormal immune responses triggered by multiple factors are closely related to the pathogenesis of IBD. Previous studies have confirmed the association of B-cell abnormal activation and increased production of autoantibodies with the development of ulcerative colitis. However, the involvement of BAFF in the mechanisms of IBD remains unclear. This review summarizes the potential role of BAFF in the pathogenesis of IBD and provides an overview of targeted therapies on BAFF in IBD, aiming to contribute insights for targeted treatments of IBD.
Keywords: Inflammatory bowel disease, B-cell activating factor, Targeted therapy
炎症性肠病(inflammatory bowel disease, IBD)是一种免疫介导的慢性肠道炎症性疾病,分为溃疡性结肠炎(ulcerative colitis, UC)、克罗恩病(Crohn's disease, CD)、炎症性肠病未定型(inflammatory bowel disease-unclassified, IBDU)3个类型,发病机制涉及肠道微环境稳态失衡、免疫功能失调、环境变化和遗传因素[ 1- 2]。既往研究显示T细胞及其释放的细胞因子在IBD的发展中起重要作用[ 3- 4],而B细胞在IBD中的作用尚不清楚。B细胞激活因子(B-cell activating factor, BAFF)是肿瘤坏死因子(tumor necrosis factor, TNF)超家族成员,因其能刺激B细胞生长而得名。它由单核细胞、巨噬细胞、树突状细胞和嗜中性粒细胞等髓系细胞产生,主要作用是维持B细胞存活、刺激其分化为浆细胞而产生抗体[ 5]。在许多自身免疫性疾病中已发现BAFF的过量产生,而BAFF抑制剂贝利尤单抗也已被批准用于治疗系统性红斑狼疮(systemic lupus erythematosus, SLE)和类风湿关节炎等自身免疫性疾病[ 6]。近年来有学者对BAFF及其靶向药物在IBD中的作用进行了相关研究,本文对其进行综述,旨在为IBD靶向治疗提供思路。
1. BAFF的结构及表达
人BAFF是由染色体13q32.34上一条全长约26 kb的mRNA编码表达的Ⅱ型跨膜蛋白,以膜结合性和可溶性2种形式存在,前者由285个氨基酸组成,经蛋白酶水解后,形成可溶性蛋白。在生理条件下,膜结合的BAFF在细胞表面表达为同源三聚体,可以被弗林蛋白酶水解,释放出具有生物活性的可溶性17 kDa分子[ 7]。BAFF与TNF超家族成员增殖诱导配体(a proliferation-inducing ligand, APRIL)的蛋白序列具有33%的同源性[ 8]。
中性粒细胞可能是BAFF的重要来源[ 9]。多种细胞因子,包括干扰素(interferon, IFN)-γ、IFN-α、转化生长因子-β(transforming growth factor, TGF-β)、白细胞介素(interleukin, IL)-10和粒细胞集落刺激因子(granulocyte colony-stimulating factor, G-CSF)能够上调BAFF在髓系细胞上的表达[ 10]。Toll样受体(Toll-like receptor, TLR)活化,特别是TLR4或TLR9,也诱导髓系细胞产生BAFF[ 11]。T细胞、活化B细胞等非髓系细胞也可产生BAFF。此外研究发现腮腺上皮细胞、星形胶质细胞、成纤维细胞样滑膜细胞、支气管上皮和非霍奇金淋巴瘤恶性B细胞也可分泌BAFF[ 12]。
2. BAFF的受体
BAFF的生物学作用由3种受体介导:BAFF受体(BAFF-receptor, BAFF-R)、B细胞成熟抗原(B-cell maturation antigen, BCMA),以及跨膜激活物、钙调节物、亲环蛋白配体相互作用物(transmembrane activator and calcium modulator and cyclophilin ligand interactor, TACI)。膜结合性及可溶性BAFF、APRIL均能与TACI、BCMA高亲和性结合,BAFF还能与BAFF-R结合[ 12]。与BAFF相比,BCMA对APRIL的亲和力更强[ 8]。BAFF-R和TACI在脾脏和外周血的成熟B细胞亚群中高表达,BCMA在骨髓浆细胞、生发中心B细胞中表达。BAFF与不同靶细胞上的不同受体结合可能介导不同的生物学功能。
2.1. BAFF-R
BAFF-R由肿瘤坏死因子受体超家族成员13C(tumor necrosis factor receptor superfamily member 13C, TNFRSF13C)基因编码,主要在B淋巴细胞上表达,在外周血单核细胞检测到较高水平[ 12]。BAFF与BAFF-R结合在促进过渡期B细胞成熟、延长成熟B细胞寿命方面具有重要意义[ 13]。A/WySnJ小鼠是Baffr基因天然突变小鼠,其B细胞发育过程被阻断,导致脾脏滤泡区及边缘区B细胞明显减少。这些小鼠的成熟外周B细胞数量减少,但骨髓B细胞生成和过渡期B细胞不受影响。Baffr突变小鼠存在抗体反应缺陷,与BAFF缺陷小鼠相似。BAFF过表达时诱导自身反应性B细胞克服死亡信号而延长生存也是通过BAFF/BAFF-R通路介导[ 14]。BAFF-R也在效应T细胞表面表达,这表明BAFF/BAFF-R通路可能在T细胞功能中发挥作用[ 15]。体内外研究证实,BAFF与CD4+T细胞亚群表达的BAFF-R结合,共同刺激T细胞活化和同种异体增殖。来自Baffr突变小鼠的T细胞对BAFF的免疫刺激作用无反应,这表明BAFF-R是促进1型T辅助细胞反应的主要受体[ 16]。
2.2. TACI
TACI是一种Ⅲ型跨膜蛋白,高亲和BAFF和APRIL。TACI主要在B细胞上表达,在记忆B细胞中的表达水平高于稳态的幼稚B细胞,可抑制B细胞扩增、促进浆细胞分化和存活。TACI通过限制B细胞诱导成熟蛋白-1克隆扩增B细胞、产生长寿命浆细胞来调节B细胞功能。TACI基因敲除小鼠出现自身免疫性疾病、恶性淋巴瘤可进一步证实这一点[ 17]。
TACI也可在非T细胞依赖性的体液免疫应答中发挥作用。研究发现TACI基因敲除小鼠对Ⅱ型抗原的非T细胞依赖性免疫应答缺失[ 15],而维持了对T细胞依赖性抗原(如锁孔帽贝血蓝蛋白)的免疫应答[ 18]。
2.3. BCMA
BCMA是由185个氨基酸残基组成的Ⅲ型跨膜蛋白,表达于生发中心B细胞和骨髓浆细胞表面。BCMA基因位于16p13,编码基因mRNA长度为1.2 kb。BCMA缺陷对外周B细胞的数量、亚型分布、平均寿命没有明显影响。BCMA在促进成熟B细胞的抗原呈递和维持浆母细胞存活方面具有重要作用。BCMA在成熟B细胞分化为浆细胞阶段表达,推测其可能在B细胞激活和终止分化中起重要作用。BCMA与转接蛋白TNF受体关联因子(TNF receptor-associated factor, TRAF)1、TRAF2和TRAF3相关,推测BCMA通过与配体结合而介导靶细胞的存活和增殖。
3. BAFF与促炎信号通路的关系
核因子κB(nuclear factor kappa B, NF-κB)活化被认为是诱导IBD的主要炎症途径[ 19]。NF-κB是由多种触发因素激活的转录因子家族,如促炎细胞因子、病原体相关分子模式,在先天性和适应性免疫中起关键作用。在IBD患者的肠黏膜上皮细胞和巨噬细胞中检测到活化的NF-κB,其表达水平与炎症强度有关。BAFF阻断剂可通过抑制NF-κB信号通路和核苷酸结合寡聚化结构域样受体蛋白3 (nucleotide-binding oligomerization domain-like receptor protein 3, NLRP3)炎性小体激活来改善结肠炎[ 20]。BAFF通过BAFF/BAFF-R通路,作用于NF-κB信号通路非经典途径,NF-κB诱导激酶可磷酸化并激活κB抑制激酶α(inhibitor of kappa B kinase α, IKKα),IKKα进一步磷酸化NF-κB2蛋白前体p100,导致p100加工并释放活性成熟p52亚基。核苷酸结合寡聚化结构域样受体家族(nucleotide-binding oligomerization domain-like receptors, NLRs)包括NLRP3等,是模式识别受体家族的亚类,与多种炎性和自身免疫性疾病的发展相关,如IBD、阿尔茨海默病、哮喘等,在激活时导致各种促炎细胞因子(如IL-1b、IL-18等)的成熟和释放,经TLR诱导,通过合成IL-1b前体和NLRP3激活NF-κB[ 21]。
BAFF也参与其他炎症途径,如BAFF通过BCMA和TACI可触发MAPK信号通路。BAFF诱导的B细胞激活实际上不依赖于ERK1/2激活,但需要ERK5激活。在B细胞中ERK5缺失导致成熟B细胞数量明显减少,BAFF上调Bcl-2家族的Mcl-1和Bcl-2a1需要ERK5参与,但ERK5缺失不影响BAFF参与促进成熟B细胞存活的PI3K-Akt及NF-κB信号转导途径的激活[ 22- 23]。
4. BAFF与IBD
近期研究表明,UC患儿与正常健康儿童相比,外周血和肠道组织中调节性B细胞数量显著降低,同时血清IL-10水平降低,Mayo评分、C反应蛋白、红细胞沉降率与调节性B细胞数量和IL-10浓度呈负相关[ 24]。结肠组织活检结果证实,UC和CD患儿结肠中BAFF mRNA和蛋白表达均高于对照组。BAFF上调主要存在于UC黏膜炎症部位的肠黏膜固有层单核细胞中。
UC、CD患儿血清和粪便中的BAFF水平高于应激性溃疡和健康对照组,与粪便钙卫蛋白表达水平显著相关[ 24]。研究表明,与对照组相比,IBD患者血清、粪便和结肠黏膜中的BAFF表达增加[ 25]。同时,血清BAFF可用于监测疾病活动度。与肠易激综合征患者相比,无论疾病活动度如何,IBD患者的血清和粪便BAFF浓度都显著增高,均高于325 pg/mL的临界值,活动性IBD患者对BAFF浓度升高具有更高的敏感性,随着疾病活动性的降低,BAFF血清水平迅速恢复到与健康受试者相似的水平[ 25]。BAFF血清水平与疾病活动性和炎症生物标志物呈正相关,表明BAFF在IBD中的作用主要是促进炎性反应。
5. BAFF和其他免疫性疾病的关系
多种自身免疫性疾病的发生发展与BAFF过表达有关。SLE患者的血BAFF显著升高,活动性患者的水平高于非活动性患者,SLE患者BAFF的高表达和不良预后密切相关[ 26]。研究表明,与健康对照相比,自身免疫性肝炎患者的血清BAFF水平显著升高,与谷丙转氨酶、谷草转氨酶、总胆红素和可溶性CD30呈正相关,这表明BAFF与自身免疫性肝炎的肝损伤、疾病发展密切相关[ 27]。BAFF很可能是一种影响自身免疫性肝炎患者循环B细胞的活性细胞因子[ 28]。在慢性阻塞性肺疾病患者和慢性香烟烟雾暴露小鼠的肺中BAFF表达显著增加,预防性和治疗性施用BAFFR-Fc后小鼠肺B细胞数量降低,慢性香烟烟雾诱导的淋巴滤泡形成减少、免疫球蛋白水平降低,显著减轻肺部炎症和肺泡壁破坏。吸烟患者的BAFF浓度高于非吸烟患者,表明BAFF与慢性阻塞性肺疾病患者的肺功能受损、缺氧严重程度相关[ 29]。
6. BAFF靶向治疗药物
基于BAFF在自身免疫性疾病发病机制中的重要作用,目前已有多种BAFF靶向治疗药物进入临床试验阶段。
6.1. 贝利尤单抗
贝利尤单抗是针对BAFF的单克隆抗体。这一中和抗体能以高亲和力形式与可溶性BAFF结合,从而有效阻断BAFF与BAFF-R、TACI、BCMA结合,其机制是特异性识别并抑制BAFF生物活性,能显著降低循环中B细胞水平。但是贝利尤单抗不能与膜结合性BAFF结合,也不能与TNF家族成员(如TNF-α、TNF-13、APRIL、IL-4和IL-8等)结合[ 13]。2019年7月,贝利尤单抗在我国获批上市。
6.2. 泰它西普
泰它西普是一种由TACI胞外区及人IgG Fc域构成的TACI-Fc融合蛋白,其中TACI可以与BAFF和APRIL结合,Fc片段可提高分子稳定性。泰它西普靶向对B淋巴细胞发育至关重要的BAFF和APRIL,能够有效降低B细胞介导的自身免疫应答,达到治疗自身免疫性疾病的目的[ 30]。2021年3月,泰它西普正式获得中国国家药品监督管理局批准上市,用于治疗SLE[ 31]。
6.3. 阿塞西普
阿塞西普由Merck Serono公司开发,也是由TACI胞外区和人IgG Fc段组成的可溶性重组融合蛋白,可选择性地杀伤成熟B细胞和浆细胞,但对原始B细胞和记忆性B细胞影响不大[ 32]。
6.4. Blisibimod
Blisibimod是一种由4个高亲和力BAFF结合结构域与人IgG Fc片段组成的融合蛋白,是由二硫键连接的2条多肽链。Blisibimod能选择性地与膜结合性和可溶性BAFF结合,以抑制BAFF与其受体的结合,从而减少B细胞存活和增殖[ 33]。
6.5. 他巴尤单抗
他巴尤单抗与贝利尤单抗类似,是一种针对BAFF的全人源单克隆抗体[ 32],能与膜结合性和可溶性BAFF结合,从而抑制BAFF介导的B细胞增殖[ 34]。
6.6. 放射性BAFF蛋白
非霍奇金淋巴瘤、B细胞慢性淋巴细胞白血病和多发性骨髓瘤等都是B系淋巴瘤,B细胞处于不受调控的恶性增殖状态,对放射性物质很敏感,可根据B细胞表面分布的特异性BAFF受体,以BAFF负载放射原对B细胞系淋巴瘤进行靶向治疗。用于靶向治疗的放射性BAFF蛋白,特异性强、杀伤力小[ 35]。
6.7. BAFF重组抑制性短肽
利用噬菌体随机肽库技术,针对特异性配体BAFF构建重组的BAFF肽段,可竞争性抑制BAFF与淋巴细胞上受体的结合,达到抑制BAFF、活化淋巴细胞的目的,从而阻断刺激单个核细胞增殖的活性,以及因T细胞、B细胞过度激活而诱导的自身免疫反应[ 36]。
6.8. BAFF类似物及BAFF-R阻滞剂
BAFF类似物可与BAFF-R竞争性结合,从而阻断信号转导来抑制BAFF的生物学功能。BAFF-R阻滞剂与BAFF-R选择性结合,同样以阻断BAFF-R与BAFF结合,达到临床治疗作用[ 37]。
7. 总结与展望
BAFF是B细胞成熟、维持存活和激活的关键参与者,可能将参与IBD的各种B细胞、T细胞、骨髓细胞和其他细胞相关机制联系起来。BAFF通过对免疫系统的多重影响可以促进肠道炎症,在BAFF抑制剂成功治疗SLE、类风湿性关节炎的推动下,靶向BAFF可能是治疗IBD中一种新颖且有前景的治疗策略。
基金资助
山东省自然科学基金(ZR2020MH144)。
利益冲突声明
所有作者均声明不存在利益冲突。
作者贡献
李琳负责收集、分析文献和文章撰写;刘海燕负责收集、分析文献和文章修改;王立俊负责确定选题及文章审阅。
参 考 文 献
- 1. Lee M, Chang EB. Inflammatory bowel diseases (IBD) and the microbiome-searching the crime scene for clues[J]. Gastroenterology, 2021, 160(2): 524-537. DOI: 10.1053/j.gastro.2020.09.056. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 2. Brnić D, Martinovic D, Zivkovic PM, et al. . Serum adropin levels are reduced in patients with inflammatory bowel diseases[J]. Sci Rep, 2020, 10(1): 9264. DOI: 10.1038/s41598-020-66254-9. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 3. Neurath MF. Cytokines in inflammatory bowel disease[J]. Nat Rev Immunol, 2014, 14(5): 329-342. DOI: 10.1038/nri3661. [ DOI] [ PubMed] [ Google Scholar]
- 4. Clough JN, Omer OS, Tasker S, et al. . Regulatory T-cell therapy in Crohn's disease: challenges and advances[J]. Gut, 2020, 69(5): 942-952. DOI: 10.1136/gutjnl-2019-319850. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 5. Cornelis R, Chang HD, Radbruch A. Keeping up with the stress of antibody production: BAFF and APRIL maintain memory plasma cells[J]. Curr Opin Immunol, 2021, 71: 97-102. DOI: 10.1016/j.coi.2021.06.012. [ DOI] [ PubMed] [ Google Scholar]
- 6. Wise LM, Stohl W. The safety of belimumab for the treatment of systemic lupus erythematosus[J]. Expert Opin Drug Saf, 2019, 18(12): 1133-1144. DOI: 10.1080/14740338.2019.1685978. [ DOI] [ PubMed] [ Google Scholar]
- 7. Schneider P, MacKay F, Steiner V, et al. . BAFF, a novel ligand of the tumor necrosis factor family, stimulates B cell growth[J]. J Exp Med, 1999, 189(11): 1747-1756. DOI: 10.1084/jem.189.11.1747. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 8. Zheng C, Zhang X, Zhao Z, et al. . Selective binding BAFF/APRIL by the in and outside conservative region of BCMA[J]. Protein Pept Lett, 2017, 24(6): 489-494. DOI: 10.2174/0929866524666170301115209. [ DOI] [ PubMed] [ Google Scholar]
- 9. Shaul ME, Zlotnik A, Tidhar E, et al. . Tumor-associated neutrophils drive B-cell recruitment and their differentiation to plasma cells[J]. Cancer Immunol Res, 2021, 9(7): 811-824. DOI: 10.1158/2326-6066.CIR-20-0839. [ DOI] [ PubMed] [ Google Scholar]
- 10. Giordano D, Kuley R, Draves KE, et al. . BAFF produced by neutrophils and dendritic cells is regulated differently and has distinct roles in antibody responses and protective immunity against West Nile virus[J]. J Immunol, 2020, 204(6): 1508-1520. DOI: 10.4049/jimmunol.1901120. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 11. Schuh E, Musumeci A, Thaler FS, et al. . Human plasmacytoid dendritic cells display and shed B cell maturation antigen upon TLR engagement[J]. J Immunol, 2017, 198(8): 3081-3088. DOI: 10.4049/jimmunol.1601746. [ DOI] [ PubMed] [ Google Scholar]
- 12. Smulski CR, Eibel H. BAFF and BAFF-receptor in B cell selection and survival[J]. Front Immunol, 2018, 9: 2285. DOI: 10.3389/fimmu.2018.02285. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 13. Vincent FB, Morand EF, Schneider P, et al. . The BAFF/APRIL system in SLE pathogenesis[J]. Nat Rev Rheumatol, 2014, 10(6): 365-373. DOI: 10.1038/nrrheum.2014.33. [ DOI] [ PubMed] [ Google Scholar]
- 14. Yang S, Li JY, Xu W. Role of BAFF/BAFF-R axis in B-cell non-Hodgkin lymphoma[J]. Crit Rev Oncol Hematol, 2014, 91(2): 113-122. DOI: 10.1016/j.critrevonc.2014.02.004. [ DOI] [ PubMed] [ Google Scholar]
- 15. Hu S, Wang R, Zhang M, et al. . BAFF promotes T cell activation through the BAFF-BAFF-R-PI3K-Akt signaling pathway[J]. Biomed Pharmacother, 2019, 114: 108796. DOI: 10.1016/j.biopha.2019.108796. [ DOI] [ PubMed] [ Google Scholar]
- 16. Salazar-Camarena DC, Ortíz-Lazareno P, Marín-Rosales M, et al. . BAFF-R and TACI expression on CD3+ T cells: interplay among BAFF, APRIL and T helper cytokines profile in systemic lupus erythematosus[J]. Cytokine, 2019, 114: 115-127. DOI: 10.1016/j.cyto.2018.11.008. [ DOI] [ PubMed] [ Google Scholar]
- 17. Mackay F, Schneider P. TACI, an enigmatic BAFF/APRIL receptor, with new unappreciated biochemical and biological properties[J]. Cytokine Growth Factor Rev, 2008, 19(3-4): 263-276. DOI: 10.1016/j.cytogfr.2008.04.006. [ DOI] [ PubMed] [ Google Scholar]
- 18. Wang QT, Ma YK, Huang B, et al. . Effect of rhTACI-Ig fusion protein on antigen-specific T cell responses from keyhole limpet haemocyanin challenged mice[J]. Mol Immunol, 2011, 49(1-2): 380-386. DOI: 10.1016/j.molimm.2011.09.007. [ DOI] [ PubMed] [ Google Scholar]
- 19. Wang B, Shen J. NF-κB inducing kinase regulates intestinal immunity and homeostasis[J]. Front Immunol, 2022, 13: 895636. DOI: 10.3389/fimmu.2022.895636. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 20. Zhang Y, Tao M, Chen C, et al. . BAFF blockade attenuates DSS-induced chronic colitis via inhibiting NLRP3 inflammasome and NF-κB activation[J]. Front Immunol, 2022, 13: 783254. DOI: 10.3389/fimmu.2022.783254. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 21. GAO P, LIU H, HUANG H, et al. . The Crohn disease-associated ATG16L1T300A polymorphism regulates inflammatory responses by modulating TLR- and NLR-mediated signaling[J]. Autophagy, 2022, 18(11): 2561-2575. DOI: 10.1080/15548627.2022.2039991. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 22. Im J, Baik JE, Lee D, et al. . Bacterial lipoproteins induce BAFF production via TLR2/MyD88/JNK signaling pathways in dendritic cells[J]. Front Immunol, 2020, 11: 564699. DOI: 10.3389/fimmu.2020.564699. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 23. Jacque E, Schweighoffer E, Tybulewicz VL, et al. . BAFF activation of the ERK5 MAP kinase pathway regulates B cell survival[J]. J Exp Med, 2015, 212(6): 883-892. DOI: 10.1084/jem.20142127. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 24. Fodor I, Serban O, Serban DE, et al. . B cell-activating factor (BAFF) in children with inflammatory bowel disease[J]. Pediatr Res, 2021, 89(7): 1798-1803. DOI: 10.1038/s41390-020-01155-1. [ DOI] [ PubMed] [ Google Scholar]
- 25. Fu Y, Wang L, Xie C, et al. . Comparison of non-invasive biomarkers faecal BAFF, calprotectin and FOBT in discriminating IBS from IBD and evaluation of intestinal inflammation[J]. Sci Rep, 2017, 7(1): 2669. DOI: 10.1038/s41598-017-02835-5. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 26. Itotagawa E, Tomofuji Y, Kato Y, et al. . SLE stratification based on BAFF and IFN-I bioactivity for biologics and implications of BAFF produced by glomeruli in lupus nephritis[J]. Rheumatology (Oxford), 2023, 62(5): 1988-1997. DOI: 10.1093/rheumatology/keac528. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 27. Migita K, Abiru S, Maeda Y, et al. . Elevated serum BAFF levels in patients with autoimmune hepatitis[J]. Hum Immunol, 2007, 68(7): 586-591. DOI: 10.1016/j.humimm.2007.03.010. [ DOI] [ PubMed] [ Google Scholar]
- 28. Biewenga M, Heidt S, Vergunst M, et al. . B-cell activating factor and IL-21 levels predict treatment response in autoimmune hepatitis[J]. JHEP Rep, 2022, 4(5): 100460. DOI: 10.1016/j.jhepr.2022.100460. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 29. Nascimento M, Huot-Marchand S, Gombault A, et al. . B-cell activating factor secreted by neutrophils is a critical player in lung inflammation to cigarette smoke exposure[J]. Front Immunol, 2020, 11: 1622. DOI: 10.3389/fimmu.2020.01622. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 30. Cai J, Gao D, Liu D, et al. . Telitacicept for autoimmune nephropathy[J]. Front Immunol, 2023, 14: 1169084. DOI: 10.3389/fimmu.2023.1169084. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 31. Dhillon S. Telitacicept: first approval[J]. Drugs, 2021, 81(14): 1671-1675. DOI: 10.1007/s40265-021-01591-1. [ DOI] [ PubMed] [ Google Scholar]
- 32. Bag-Ozbek A, Hui-Yuen JS. Emerging B-cell therapies in systemic lupus erythematosus[J]. Ther Clin Risk Manag, 2021, 17: 39-54. DOI: 10.2147/TCRM.S252592. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 33. Magro R. Biological therapies and their clinical impact in the treatment of systemic lupus erythematosus[J]. Ther Adv Musculoskelet Dis, 2019, 11: 1759720X19874309. DOI: 10.1177/1759720X19874309. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 34. Manetta J, Bina H, Ryan P, et al. . Generation and characterization of tabalumab, a human monoclonal antibody that neutralizes both soluble and membrane-bound B-cell activating factor[J]. J Inflamm Res, 2014, 7: 121-131. DOI: 10.2147/JIR.S67751. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 35. Riccobene TA, Miceli RC, Lincoln C, et al. . Rapid and specific targeting of 125I-labeled B lymphocyte stimulator to lymphoid tissues and B cell tumors in mice[J]. J Nucl Med, 2003, 44(3): 422-433. [ PubMed] [ Google Scholar]
- 36. Wu W, Li S, Zhang W, et al. . A novel VHH antibody targeting the B cell-activating factor for B-cell lymphoma[J]. Int J Mol Sci, 2014, 15(6): 9481-9496. DOI: 10.3390/ijms15069481. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]
- 37. McWilliams EM, Lucas CR, Chen T, et al. . Anti-BAFF-R antibody VAY-736 demonstrates promising preclinical activity in CLL and enhances effectiveness of ibrutinib[J]. Blood Adv, 2019, 3(3): 447-460. DOI: 10.1182/bloodadvances.2018025684. [ DOI] [ PMC free article] [ PubMed] [ Google Scholar]