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The emerging role of Janus kinase inhibitors in the treatment of autoimmune and inflammatory diseases - 04/03/21

Doi : 10.1016/j.jaci.2020.10.022 
William Damsky, MD, PhD a, , Danielle Peterson, MD a, Julie Ramseier, MD a, Badr Al-Bawardy, MD b, Hyung Chun, MD c, Deborah Proctor, MD b, Vibeke Strand, MD d, Richard A. Flavell, PhD e, f, Brett King, MD, PhD a,
a Department of Dermatology, Yale University School of Medicine, New Haven, Conn 
b Division of Digestive Diseases, Yale University School of Medicine, New Haven, Conn 
c Division of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Conn 
d Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, Calif 
e Department of Immunobiology, Yale University School of Medicine, New Haven, Conn 
f Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, Conn 

Corresponding authors: William Damsky, MD, PhD, Department of Dermatology, Yale School of Medicine, 333 Cedar St, LCI 501, PO Box 208059, New Haven, CT, 06510.Department of DermatologyYale School of Medicine333 Cedar StLCI 501PO Box 208059New HavenCT06510∗∗Brett King, MD, Department of Dermatology, Yale School of Medicine, 333 Cedar St, LCI 501, PO Box 208059, New Haven, CT, 06510.Department of DermatologyYale School of Medicine333 Cedar StLCI 501PO Box 208059New HavenCT06510

Abstract

Autoimmune and inflammatory diseases are common and diverse, and they can affect nearly any organ system. Much of the pathogenesis of these diseases is related to dysregulated cytokine activity. Historically, autoimmune and inflammatory diseases have been treated with medications that nonspecifically suppress the immune system. mAbs that block the action of pathogenic cytokines emerged 2 decades ago and have become widely useful. More recently, agents that simultaneously block multiple pathogenic cytokines via inhibition of the downstream Janus kinase (JAK)–signal transducer and activator of transcription pathway have emerged and are becoming increasingly important. These small-molecule inhibitors, collectively termed JAK inhibitors, are US Food and Drug Administration–approved in a few autoimmune/inflammatory disorders and are being evaluated in many others. Here, we review the biology of the JAK–signal transducer and activator of transcription pathway and the use of JAK inhibitors to treat autoimmune and inflammatory diseases across medical subspecialties.

Il testo completo di questo articolo è disponibile in PDF.

Key words : Autoimmune disease, baricitinib, inflammatory disease, JAK inhibitor, Janus kinase inhibitor, JAK-STAT, ruxolitinib, tofacitinib, upadacitinib, cytokine

Abbrevations used : CBC, CD, FDA, GVHD, HES, HLH, IBD, JAK, LFT, RA, STAT, UC


Mappa


 W.D. is supported by a Career Development Award form the Dermatology Foundation. B.K. is supported by the Ranjini and Ajay Poddar Fund for Dermatologic Diseases Research. R.A.F. is a Howard Hughes Medical Institute Investigator. The funding sources had no direct involvement in this work.
 Disclosure of potential conflict of interest: W. Damsky receives research support from Pfizer, has served as a consultant for Eli Lilly, and receives licensing fees from EMD/Sigma/Millipore in unrelated work. H. Chun receives research support from Pfizer. V. Strand serves as a consultant to AbbVie, Amgen Corporation, Arena, AstraZeneca, Bayer, Blackrock, Bioventus, BMS, Boehringer Ingelheim, Celltrion, Concentric Analgesics, Crescendo/Myriad Genetics, EMD Serono, Equilium, Eupraxia, Flexion, Galapagos, Genentech/Roche, Gilead, GSK, Horizon, Ichnos, Inmedix, Janssen, Kiniksa, Kypha, Lilly, Merck, MiMedx, MyoKardia, Novartis, Pfizer, Regeneron, Samsung, Samumed, Sandoz, Sanofi, Servier, Setpoint, Tonix, and UCB. B. King is an investigator for Concert Pharmaceuticals Inc, Eli Lilly and Company, and Pfizer Inc. In addition, B. King is a consultant to and/or has served on advisory boards for Aclaris Therapeutics, Arena Pharmaceuticals, Bristol-Meyers Squibb, Concert Pharmaceuticals Inc, Dermavant Sciences, Eli Lilly and Company, Pfizer Inc, and VielaBio, and he is on the speaker bureau for Regeneron and Sanofi Genzyme. R. A. Flavell is a consultant for GlaxoSmithKline and Zai Lab Limited. The rest of the authors declare that they have no relevant conflicts of interest.


© 2020  American Academy of Allergy, Asthma & Immunology. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 147 - N° 3

P. 814-826 - Marzo 2021 Ritorno al numero
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