Menshawey Rahma, Menshawey Esraa, Alserr Ayman H K, Abdelmassih Antoine Fakhry
Research Department, Students' and Interns' Research Program (Research Accessibility Team), Cairo University Kasr al Ainy Faculty of Medicine.
Department of Vascular Surgery.
Cardiovasc Endocrinol Metab. 2020 Oct 15;10(2):80-88. doi: 10.1097/XCE.0000000000000237. eCollection 2021 Jun.
The adaptive use of Janus kinase (JAK)-inhibitors has been suggested by rheumatology experts in the management of COVID-19. We recount the rationale behind their use in this setting, and the current evidence for and against their use in this review. JAK-inhibitors role in COVID-19 infection appears to be multifaceted, including preventing viral endocytosis and dampening the effect of excessive chemokines. This drug class may be able to achieve these effects at already preapproved dosages. Concerns arise regarding reactivation of latent viral infections and the feasibility of their use in those with severe disease. Most interestingly, JAK-Inhibitors may also have an additional advantage for diabetic and obese populations, where the dysregulation of JAK-signal transducer and activator of transcription pathway may be responsible for their increased risk of poor outcomes. Targeting this pathway may provide a therapeutic advantage for these patient groups.
风湿病专家建议在新冠病毒疾病（COVID-19）的管理中适应性使用 Janus 激酶（JAK）抑制剂。在本综述中，我们阐述了在这种情况下使用它们的基本原理，以及目前支持和反对使用它们的证据。JAK 抑制剂在 COVID-19 感染中的作用似乎是多方面的，包括防止病毒内吞作用和减轻过量趋化因子的影响。这类药物可能能够以已获批的剂量实现这些效果。对于潜伏病毒感染的重新激活以及它们在重症患者中使用的可行性存在担忧。最有趣的是，JAK 抑制剂对于糖尿病和肥胖人群可能还有额外的优势，在这些人群中，JAK 信号转导子和转录激活子途径的失调可能是他们不良结局风险增加的原因。针对这一途径可能为这些患者群体提供治疗优势。
