Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, NY.
National Jewish Medical Center, Denver, Colo.
J Allergy Clin Immunol. 2021 Oct;148(4):953-963. doi: 10.1016/j.jaci.2021.08.013.
Asthma is an inflammatory disease of the airways characterized by intermittent episodes of wheezing, chest tightness, and cough. Many of the inflammatory pathways implicated in asthma involve cytokines and growth factors that activate Janus kinases (JAKs). The discovery of the JAK/signal transducer and activator of transcription (STAT) signaling pathway was a major breakthrough that revolutionized our understanding of cell growth and differentiation. JAK inhibitors are under active investigation for immune and inflammatory diseases, and they have demonstrated clinical efficacy in diseases such as rheumatoid arthritis and atopic dermatitis. Substantial preclinical data support the idea that inhibiting JAKs will ameliorate airway inflammation and hyperreactivity in asthma. Here, we review the rationale for use of JAK inhibitors in different asthma endotypes as well as the preclinical and early clinical evidence supporting such use. We review preclinical data from the use of systemic and inhaled JAK inhibitors in animal models of asthma and safety data based on the use of JAK inhibitors in other diseases. We conclude that JAK inhibitors have the potential to usher in a new era of anti-inflammatory treatment for asthma.
哮喘是一种气道炎症性疾病,其特征是间歇性喘息、胸闷和咳嗽。许多涉及哮喘的炎症途径涉及细胞因子和生长因子,这些因子激活了 Janus 激酶(JAK)。JAK/信号转导和转录激活因子(STAT)信号通路的发现是一个重大突破,彻底改变了我们对细胞生长和分化的理解。JAK 抑制剂正在积极研究用于免疫和炎症性疾病,并且在类风湿关节炎和特应性皮炎等疾病中已显示出临床疗效。大量临床前数据支持这样一种观点,即抑制 JAK 可改善哮喘中的气道炎症和高反应性。在这里,我们回顾了在不同哮喘表型中使用 JAK 抑制剂的原理,以及支持这种使用的临床前和早期临床证据。我们回顾了在哮喘动物模型中使用全身性和吸入性 JAK 抑制剂的临床前数据以及基于在其他疾病中使用 JAK 抑制剂的安全性数据。我们的结论是,JAK 抑制剂有可能开创哮喘抗炎治疗的新时代。