The Second Hospital of Jilin University Nephropathy of Internal Medicine, Changchun, 130022, China.
Eur J Med Res. 2023 Sep 22;28(1):369. doi: 10.1186/s40001-023-01320-2.
IgA nephropathy (IgAN) is the most common primary glomerular disease in the world, and up to 40% of patients with IgAN develop end-stage renal disease (ESRD). At present, an increasing amount of evidence indicates that the pathogenesis of IgAN is related to autoimmunity. In recent years, several studies have shown that B cell activating factors (BAFF), also known as B lymphocyte stimulators (BLyS), and proliferation-inducing ligand APRIL are extremely important for the activation of autoimmune signalling pathways, which have become key targets for the treatment of IgAN. As a dual-target biological agent, telitacicept can inhibit both BLyS and APRIL cytokines, improve the function of renal immune complexes, and reduce haematuria and proteinuria, which play important roles in IgAN pathogenesis and long-term prognosis. This article reviews the role of telitacicept in IgA nephropathy and discusses its potential for use in the treatment of IgAN and other autoimmune diseases where pathogenesis is driven by B cells.
IgA 肾病（IgAN）是世界上最常见的原发性肾小球疾病，多达 40%的 IgAN 患者发展为终末期肾病（ESRD）。目前，越来越多的证据表明，IgAN 的发病机制与自身免疫有关。近年来，多项研究表明，B 细胞激活因子（BAFF），也称为 B 淋巴细胞刺激因子（BLyS）和增殖诱导配体 APRIL，对自身免疫信号通路的激活非常重要，已成为 IgAN 治疗的关键靶点。作为一种双靶点生物制剂，替利妥昔单抗可同时抑制 BLyS 和 APRIL 细胞因子，改善肾脏免疫复合物的功能，减少血尿和蛋白尿，在 IgAN 的发病机制和长期预后中发挥重要作用。本文综述了替利妥昔单抗在 IgA 肾病中的作用，并探讨了其在 IgAN 及其他由 B 细胞驱动的自身免疫性疾病治疗中的应用潜力。
