Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus

Abstract Background Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease marked by B cell activation and autoantibody formation. Telitacicept, a dual inhibitor of the B cell pathway, neutralizes signals from B lymphocyte stimulator and a proliferation-inducing ligand. The aim of...

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Main Authors: Xiaowei Chen, Lingzhen Hu, Lingxiao Zhu, Jianxin Tu, Jiajun Gui, Mengyuan Fang, Li Sun
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Arthritis Research & Therapy
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Online Access:https://doi.org/10.1186/s13075-025-03584-x
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author Xiaowei Chen
Lingzhen Hu
Lingxiao Zhu
Jianxin Tu
Jiajun Gui
Mengyuan Fang
Li Sun
author_facet Xiaowei Chen
Lingzhen Hu
Lingxiao Zhu
Jianxin Tu
Jiajun Gui
Mengyuan Fang
Li Sun
author_sort Xiaowei Chen
collection DOAJ
description Abstract Background Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease marked by B cell activation and autoantibody formation. Telitacicept, a dual inhibitor of the B cell pathway, neutralizes signals from B lymphocyte stimulator and a proliferation-inducing ligand. The aim of this study is to investigate the changes in detailed B cell subsets in SLE patients following Telitacicept treatment. Methods Twenty active SLE patients (SLEDAI-2 K ≥ 6) were enrolled, with B cell subsets analyses and clinical assessments conducted at 0, 4, 12, and 24 weeks after initiating Telitacicept treatment. Additionally, B cell subsets were measured in 21 healthy controls. Flow cytometry was used to quantify B cell subsets. Results After six months of treatment, a 95% (19/20) SRI-4 response rate and a 35% (7/20) achievement of LLDAS were recorded. Compared to baseline, there were significant reductions in SLEDAI-2 K scores and anti-dsDNA levels (both p < 0.001), along with increases in complement C3 and C4 levels (both p < 0.001). Additionally, there was a significant decrease in 24-h urine protein levels (p = 0.004). B cell subset analysis revealed decreases in total B cells (p < 0.05), transitional B cells, naive B cells, and short-lived plasma cells (all p < 0.01). The proportion of B regulatory (Breg) cell increased (p < 0.05). Conclusion Combining telitacicept with standard therapy induced significant changes in B cell subsets and clinical markers in SLE patients. The reduction in naive and transitional B cells, along with the restoration of Breg cell, suggests a potential positive influence on immunoregulatory capacity. Trial registration Chineses Clinical Trials Registry; https://www.chictr.org.cn ; ChiCTR2400086874.
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spelling doaj-art-32ed2c271cf249d480239f6c86ad08362025-08-20T02:37:34ZengBMCArthritis Research & Therapy1478-63622025-06-0127111010.1186/s13075-025-03584-xProspective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosusXiaowei Chen0Lingzhen Hu1Lingxiao Zhu2Jianxin Tu3Jiajun Gui4Mengyuan Fang5Li Sun6Department of Rheumatology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Rheumatology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Rheumatology, Jinhua Municipal Central HospitalDepartment of Rheumatology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Rheumatology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Rheumatology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Rheumatology, The First Affiliated Hospital of Wenzhou Medical UniversityAbstract Background Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease marked by B cell activation and autoantibody formation. Telitacicept, a dual inhibitor of the B cell pathway, neutralizes signals from B lymphocyte stimulator and a proliferation-inducing ligand. The aim of this study is to investigate the changes in detailed B cell subsets in SLE patients following Telitacicept treatment. Methods Twenty active SLE patients (SLEDAI-2 K ≥ 6) were enrolled, with B cell subsets analyses and clinical assessments conducted at 0, 4, 12, and 24 weeks after initiating Telitacicept treatment. Additionally, B cell subsets were measured in 21 healthy controls. Flow cytometry was used to quantify B cell subsets. Results After six months of treatment, a 95% (19/20) SRI-4 response rate and a 35% (7/20) achievement of LLDAS were recorded. Compared to baseline, there were significant reductions in SLEDAI-2 K scores and anti-dsDNA levels (both p < 0.001), along with increases in complement C3 and C4 levels (both p < 0.001). Additionally, there was a significant decrease in 24-h urine protein levels (p = 0.004). B cell subset analysis revealed decreases in total B cells (p < 0.05), transitional B cells, naive B cells, and short-lived plasma cells (all p < 0.01). The proportion of B regulatory (Breg) cell increased (p < 0.05). Conclusion Combining telitacicept with standard therapy induced significant changes in B cell subsets and clinical markers in SLE patients. The reduction in naive and transitional B cells, along with the restoration of Breg cell, suggests a potential positive influence on immunoregulatory capacity. Trial registration Chineses Clinical Trials Registry; https://www.chictr.org.cn ; ChiCTR2400086874.https://doi.org/10.1186/s13075-025-03584-xSystemic lupus erythematosusB cell subsetsTelitacicept
spellingShingle Xiaowei Chen
Lingzhen Hu
Lingxiao Zhu
Jianxin Tu
Jiajun Gui
Mengyuan Fang
Li Sun
Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
Arthritis Research & Therapy
Systemic lupus erythematosus
B cell subsets
Telitacicept
title Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
title_full Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
title_fullStr Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
title_full_unstemmed Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
title_short Prospective analysis of B cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
title_sort prospective analysis of b cell subset dynamics following telitacicept treatment in systemic lupus erythematosus
topic Systemic lupus erythematosus
B cell subsets
Telitacicept
url https://doi.org/10.1186/s13075-025-03584-x
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