Tan Jinhui, Huang Hai, Tan Linghua, Li Bo
Department of Rheumatology and Immunology, People's Hospital of Longhua, Shenzhen, Guangdong 518109, P.R. China.
Department of Health Management, People's Hospital of Longhua, Shenzhen, Guangdong 518109, P.R. China.
Biomed Rep. 2025 Jan 19;22(3):48. doi: 10.3892/br.2025.1926. eCollection 2025 Mar.
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a complex etiology primarily linked to abnormalities in B lymphocytes within the human body, resulting in the production of numerous pathogenic autoantibodies. Telitacicept is a relatively novel humanized, recombinant transmembrane activator, calcium modulator and cyclophilin ligand interactor fused with the Fc portion (TACI-Fc). It works by competitively inhibiting the TACI site, neutralizing the activity of B-cell lymphocyte stimulator and A proliferation-inducing ligand. This, in turn, inhibits the development and survival of plasma cells and mature B cells. A 28-year-old female was admitted to the Department of Rheumatology and Immunology (People's Hospital of Longhua; Shenzhen, China) in June 2021 due to systemic edema for more than a month and hair loss lasting for a week. After comprehensive examination, the patient was diagnosed with SLE with hematological system involvement, serositis, lupus nephritis and secondary antiphospholipid syndrome. After receiving medications including glucocorticoids, mycophenolate mofetil and cyclosporine, the patient's white blood cells, platelets, hemoglobin, urinary protein and multiple serositis returned to normal. However, the levels of complement 3 (C3) and C4 did not significantly improve. Subsequently, the patient underwent thyroid ultrasound examination, which suggested thyroid nodules. After thyroid puncture biopsy, the patient was diagnosed with papillary thyroid carcinoma (PTC). After surgical resection, the patient was confirmed to have PTC by pathological biopsy, with no lymph node metastasis. At two months after surgery, the patient was treated with telitacicept, and the complement levels not only returned to normal but also remained stable for a long time. The present case was the first to report the use of telitacicept for the successful treatment of a patient with SLE with post-surgical PTC, providing a potential therapeutic option for SLE with a prior history of carcinoma. The role of telitacept in this field requires further research and attention.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，病因复杂，主要与人体内B淋巴细胞异常有关，导致产生大量致病性自身抗体。泰它西普是一种相对新型的人源化重组跨膜激活剂、钙调蛋白和环孢素配体相互作用分子与Fc部分融合的蛋白（TACI-Fc）。它通过竞争性抑制TACI位点，中和B细胞淋巴细胞刺激因子和增殖诱导配体的活性来发挥作用。这进而抑制浆细胞和成熟B细胞的发育和存活。一名28岁女性于2021年6月因全身水肿一个多月和脱发一周入住龙华区人民医院（中国深圳）风湿免疫科。综合检查后，患者被诊断为SLE，伴有血液系统受累、浆膜炎、狼疮性肾炎和继发性抗磷脂综合征。在接受包括糖皮质激素、霉酚酸酯和环孢素在内的药物治疗后，患者的白细胞、血小板、血红蛋白、尿蛋白和多处浆膜炎恢复正常。然而，补体3（C3）和C4水平并未显著改善。随后，患者接受甲状腺超声检查，提示甲状腺结节。甲状腺穿刺活检后，患者被诊断为甲状腺乳头状癌（PTC）。手术切除后，病理活检证实患者患有PTC，无淋巴结转移。术后两个月，患者接受泰它西普治疗，补体水平不仅恢复正常，而且长期保持稳定。本病例首次报道了使用泰它西普成功治疗一名患有SLE且术后患有PTC的患者，为有癌症病史的SLE患者提供了一种潜在的治疗选择。泰它西普在该领域的作用需要进一步研究和关注。
