OBJECTIVE: To study the expression level of serum B-cell maturation antigen (sBCMA) in the peripheral blood of newly diagnosed multiple myeloma (MM) patients, and explore its relationship with the prognosis of MM patients. METHODS: The peripheral blood of 31 newly diagnosed MM patients and 30 healthy volunteers were collected. The level of sBCMA in the peripheral blood was detected by enzyme-linked immunosorbent assay (ELISA). The correlation between the level of sBCMA and the prognosis of MM patients was analyzed. RESULTS: The level of sBCMA in newly diagnosed MM patients was significantly higher than that in healthy controls (P <0.05). The level of sBCMA was closely related to the plasma cells ratio in bone marrow, the M protein level and the treatment (P <0.05). The level of sBCMA was negatively correlated with the overall survival (OS) of MM patients (r =-0.47). MM patients with low expression of sBCMA had significantly longer OS than patients with high expression of sBCMA (P <0.05). CONCLUSION The level of sBCMA is significantly increased in MM patients, which is expected to be a new indicator for evaluating the curative efficacy and prognosis of MM patients. Targeting sBCMA may provide new ideas for the treatment of MM.
Humans ; Multiple Myeloma ; B-Cell Maturation Antigen/metabolism* ; Prognosis

Abstract　　B cell maturation antigen (BCMA) is an ideal target for precise treatment due to its highly selective expression on malignant myeloma cells. This review summarizes briefly the advances in the latest research progress on biological activity of BCMA, its significance as a biomarker and immunotherapy direcited against BCMA, such as bispecific antibodies, antibody drug conjugates, chimeric antigen receptor T cell therapy against mature B cell antigens.
Antigens, Differentiation, B-Lymphocyte ; B-Cell Maturation Antigen ; B-Lymphocytes ; Humans ; Immunotherapy ; Multiple Myeloma ; therapy ; T-Lymphocytes

OBJECTIVE: To investigate the toxicity management and efficacy evaluation of BCMA-chimeric antigen receptor T cells(CART) in the treatment of relapsed and refractory multiple myeloma (MM). METHODS: The efficacy and adverse reactions of 21 patients with MM who received BCMA-CART treatment at the First Affiliated Hospital of Wenzhou Medical University from December 2017 to September 2020 were evaluated, and the efficacy assessment and survival analysis for high-risk patients and non-high-risk patients were evaluated. RESULTS: After infusion of BCMA-CART cells in 21 MM patients, the number of effective cases was 17, of which the complete remission (sCR/CR) was 10, and the partial remission (VGPR/PR) was 7. The median OS time for all patients was 19.4 months, and the median PFS time was 7.9 months. The number of patients with extramedullary disease(EMD), high-risk genetics, and ISS stage Ⅲ were 5, 15 and 8, and the effective number was 3, 11 and 6, respectively. The treatment of 3 patients without high-risk factors was effective. The median OS and median PFS of patients with EMD were 14.2 and 2.5 months, respectively, which were shorter than those of patients without EMD (19.4 months and 8.9 months, respectively). The median OS and median PFS of patients with high-risk cytogenetic factors and ISS Ⅲ were not significantly different from those of non-high-risk patients. Cytokine release syndrane (CRS) occurred in 20 patients, of which 14 cases were Grade 1 CRS, while 6 were Grade 2, no CRS of Grade 3 or above occurred. IL-6 receptor inhibitors were used in 9 patients. All CRS were controlled effectively, and no patients had neurological toxicity. CONCLUSION BCMA-CART is a certain curative effect in the treatment of relapsed and refractory multiple myeloma, and the adverse reactions can be well controlled through close monitoring and timely treatment.
B-Cell Maturation Antigen ; Humans ; Immunotherapy, Adoptive/adverse effects* ; Multiple Myeloma/therapy* ; Receptors, Chimeric Antigen ; Remission Induction

B cell activating factor (BAFF) is one of the TNF family member, regulates the survival and maturation of B lymphocyte. BAFF binds to three receptors: BCMA, TACI and BAFF-R. In recent years, studies have revealed important roles of BAFF and its receptors in immune regulation of antibody isotype switching, germinal center maintenance, and T cell co-stimulation, that may provide new drugs in the future for the treatment of autoimmune disorders, lymphoma and B cell immunodeficiencies. Therefore, the structure, expression, receptors, biological function and clinical application of BAFF are briefly summarized in this review.
B-Cell Activating Factor ; immunology ; B-Cell Activation Factor Receptor ; immunology ; B-Cell Maturation Antigen ; immunology ; B-Lymphocytes ; immunology ; Humans ; Immunity ; Transmembrane Activator and CAML Interactor Protein ; immunology

Many studies show that as a transcription factor, B lymphocyte-induced maturation protein 1 (Blimp 1) is the master regulator of plasma-cell differentiation. The abnormality of Blimp 1 plays an important part in the genesis and development of lymphoma. This review introduces and summarizes Blimp 1's protein structure and functions, its role in B cell differentiation, its main target genes and the mechanism of its transcriptional repressor activity. Besides, the relationship between Blimp 1 gene mutation or Blimp 1 protein expression reduction and the development of DLBCL is preliminary summaried.
B-Cell Maturation Antigen ; genetics ; B-Lymphocytes ; Cell Differentiation ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Positive Regulatory Domain I-Binding Factor 1 ; Repressor Proteins ; metabolism ; Transcription Factors

Objective:b> To explore the dynamic changes in serum lipid levels and nutritional status during BCMA-CAR-T-cell therapy in patients with refractory or relapsed multiple myeloma (R/R MM) based on LEGEND-2. Methods:b> The data of patients with R/R MM who underwent BCMA-CAR-T therapy at our hospital between March 30, 2016, and February 6, 2018, were retrospectively collected. Serum lipid levels, controlled nutritional status (CONUT) score, and other clinical indicators at different time points before and after CAR-T-cell infusion were compared and analyzed. The best cut-off value was determined by using the receiver operator characteristic (ROC) curve. The patients were divided into high-CONUT score (>6.5 points, malnutrition group) and low-CONUT score groups (≤6.5 points, good nutrition group), comparing the progression-free survival (PFS) and total survival (OS) of the two groups using Kaplan-Meier survival analysis. Results:b> Before the infusion of CAR-T-cells, excluding triglycerides (TG), patients' serum lipid levels were lower than normal on average. At 8-14 d after CAR-T-cell infusion, serum albumin (ALB), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and apolipoprotein A1 (Apo A1) levels dropped to the minimum, whereas CONUT scores reached the maximum. In addition to TG, apolipoprotein B (Apo B) levels increased compared with baseline. After CAR-T-cell therapy, the patients' serum lipid levels significantly increased with well-improved nutritional status. Spearman's related analysis showed that TC, HDL, and ApoA1 levels after CAR-T-cell injection were significantly negatively correlated with the grade of cytokine-release syndrome (CRS) (r=-0.548, P=0.003; r=-0.444, P=0.020; r=-0.589, P=0.001). Furthermore, survival analysis indicated that the CONUT score was unrelated to PFS, and the median OS of patients with R/R MM in the high-CONUT score group was shorter than that in the low-CONUT score group (P=0.046) . Conclusions:b> During CAR-T-cell therapy, hypolipidemia and poor nutritional status were aggravated, which is possibly related to CRS. The patients' serum lipid levels and nutritional status were significantly improved after CAR-T-cell treatment. The CONUT score affected the median OS in patients treated with CAR-T-cells. Therefore, specific screening and intervention for nutritional status in patients receiving CAR-T-cell therapy are required.
Humans ; Multiple Myeloma/drug therapy* ; Nutritional Status ; Retrospective Studies ; Receptors, Chimeric Antigen/therapeutic use* ; B-Cell Maturation Antigen/therapeutic use* ; Cell- and Tissue-Based Therapy ; Lipids/therapeutic use*

Objective:b> To observe the characteristics of the evolution of liver indexes in patients with relapsed/refractory multiple myeloma (RRMM) treated with CAR-T-cells based on BCMA. Methods:b> Retrospective analysis was performed of patients with RRMM who received an infusion of anti-BCMA CAR-T-cells and anti-BCMA combined with anti-CD19 CAR-T-cells at our center between June 1, 2019, and February 28, 2023. Clinical data were collected to observe the characteristics of changes in liver indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and direct bilirubin (DBIL) in patients, and its relationship with cytokine-release syndrome (CRS) . Results:b> Ninety-two patients were included in the analysis, including 41 patients (44.6%) in the group receiving a single infusion of anti-BCMA CAR-T-cells, and 51 patients (55.4%) in the group receiving an infusion of anti-BCMA combined with anti-CD19 CAR-T-cells. After infusing CAR-T-cells, 31 patients (33.7%) experienced changes in liver indexes at or above grade 2, which included 20 patients (21.7%) with changes in one index, five patients (5.4%) with changes in two indexes, and six patients (6.5%) with changes in three or more indexes. The median time of peak values of ALT and AST were d17 and d14, respectively, and the median duration of exceeding grade 2 was 5.0 and 3.5 days, respectively. The median time of peak values of TBIL and DBIL was on d19 and d21, respectively, and the median duration of exceeding grade 2 was 4.0 days, respectively. The median time of onset of CRS was d8, and the peak time of fever was d9. The ALT, AST, and TBIL of patients with CRS were higher than those of patients without CRS (P=0.011, 0.002, and 0.015, respectively). CRS is an independent factor that affects ALT and TBIL levels (OR=19.668, 95% CI 18.959-20.173, P=0.001). The evolution of liver indexes can be reversed through anti-CRS and liver-protection treatments, and no patient died of liver injury. Conclusions:b> In BCMA-based CAR-T-cell therapy for RRMM, CRS is an important factor causing the evolution of liver indexes. The evolution of liver indexes after CAR-T-cell infusion is transient and reversible after treatment.
Humans ; Antigens, CD19 ; B-Cell Maturation Antigen/therapeutic use* ; Bilirubin ; Immunotherapy, Adoptive ; Liver ; Multiple Myeloma/drug therapy* ; Retrospective Studies ; T-Lymphocytes

BCMA is one of the transmembrane receptors belonging to BAFF and APRIL. In order to identify the feasibility of sBCMA as decoy receptor and obtain active sBCMA for its structural and functional research, full length of hBCMA was amplified with total RNA from Raji cell line by RT-PCR, and the cDNA encoding the extracelluar soluble domain of hBCMA was inserted into pET43.1a(+) vector. The recombinant vector pET43.1a(+)-sBCMA was transformed into E. coli Origami B(DE3) pLyS which is helpful for disulfide bond construction of expression proteins. After IPTG induction, the recombinant protein was expressed as soluble fusion protein, sBCMA-NusA-His6, and identified by western blotting. Then the target protein was purified by Ni(+)-chelating Sepharose Fast Flow. The binding activity between recombinant sBCMA and BAFF was detected by ELISA. Also, Recombinant sBCMA inhibited proliferation of mouse B cell stimulating by rhsBAFF. It was proved that recombinant sBCMA has good bioactivity and the method to express those proteins rich in disulfide bond is feasible and effectual.
B-Cell Activating Factor ; chemistry ; B-Cell Maturation Antigen ; biosynthesis ; genetics ; Cloning, Molecular ; DNA, Complementary ; genetics ; Disulfides ; chemistry ; Escherichia coli ; genetics ; metabolism ; Humans ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Solubility ; Tumor Necrosis Factor Ligand Superfamily Member 13 ; chemistry

Multiple myeloma (MM), considered an incurable hematological malignancy, is characterized by its clonal evolution of malignant plasma cells. Although the application of autologous stem cell transplantation (ASCT) and the introduction of novel agents such as immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs) have doubled the median overall survival to eight years, relapsed and refractory diseases are still frequent events in the course of MM. To achieve a durable and deep remission, immunotherapy modalities have been developed for relapsed/refractory multiple myeloma (RRMM). Among these approaches, chimeric antigen receptor (CAR) T-cell therapy is the most promising star, based on the results of previous success in B-cell neoplasms. In this immunotherapy, autologous T cells are engineered to express an artificial receptor which targets a tumor-associated antigen and initiates the T-cell killing procedure. Tisagenlecleucel and Axicabtagene, targeting the CD19 antigen, are the two pacesetters of CAR T-cell products. They were approved by the US Food and Drug Administration (FDA) in 2017 for the treatment of acute lymphocytic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). Their development enabled unparalleled efficacy in combating hematopoietic neoplasms. In this review article, we summarize six promising candidate antigens in MM that can be targeted by CARs and discuss some noteworthy studies of the safety profile of current CAR T-cell therapy.
ADP-ribosyl Cyclase 1/immunology* ; B-Cell Maturation Antigen/immunology* ; Humans ; Immunotherapy, Adoptive/methods* ; Multiple Myeloma/therapy* ; Receptors, Chimeric Antigen/immunology* ; Receptors, G-Protein-Coupled/immunology* ; Signaling Lymphocytic Activation Molecule Family/immunology* ; Syndecan-1/immunology* ; T-Lymphocytes/immunology*

B lymphocyte stimulator (BLyS), a tumor neurosis factor ligand superfamily, is an important factor of B cell survival and activation. However, BLyS also regulates T cell activation and survival, playing key roles in T cell-mediated autoimmune disorders. In the paper, we introduced the mechanisms of BLyS and a proliferation-inducing ligand (APRIL) regulating T cell responses and their roles in rheumatoid arthritis (RA).
Animals ; Antibodies, Monoclonal, Humanized ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; metabolism ; pathology ; B-Cell Activating Factor ; metabolism ; B-Cell Activation Factor Receptor ; metabolism ; B-Cell Maturation Antigen ; metabolism ; B-Lymphocytes ; metabolism ; pathology ; Humans ; Lymphocyte Activation ; Recombinant Fusion Proteins ; therapeutic use ; T-Lymphocytes ; metabolism ; pathology ; Transmembrane Activator and CAML Interactor Protein ; metabolism ; Tumor Necrosis Factor Ligand Superfamily Member 13 ; metabolism