Nakayamada Shingo, Tanaka Yoshiya
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Expert Rev Clin Immunol. 2022 Mar;18(3):245-252. doi: 10.1080/1744666X.2022.2040988. Epub 2022 Feb 17.
The pathogenesis of systemic lupus erythematosus (SLE) involves abnormalities in both acquired and innate immune system, which is mediated by numerous cytokines. Janus kinase (JAK) plays important roles in the signaling pathways of those cytokines and is an attractive therapeutic target for SLE. Currently, multiple clinical trials using JAK inhibitors with different selectivities for JAK family proteins are being conducted in SLE.
In this article, we provide an overview of the pathological relevance of JAK and the clinical implications of JAK inhibitors in SLE based on recent reports.
JAK inhibitors have the potential to modulate various immune networks through a variety of mechanisms, potentially regulating the complex immunopathogenesis in SLE. SLE is a clinically and immunologically heterogeneous disease; therefore, precision medicine is required to maximize the efficacy of JAK inhibitors. Further studies are needed to determine their risk-benefit ratio and selection of the most appropriate patients for JAK inhibitors.
系统性红斑狼疮(SLE)的发病机制涉及获得性免疫系统和先天性免疫系统的异常,这是由多种细胞因子介导的。Janus激酶(JAK)在这些细胞因子的信号通路中起重要作用,是SLE一个有吸引力的治疗靶点。目前,正在对SLE开展多项使用对JAK家族蛋白具有不同选择性的JAK抑制剂的临床试验。
在本文中,我们根据近期报告概述了JAK的病理相关性以及JAK抑制剂在SLE中的临床意义。
JAK抑制剂有可能通过多种机制调节各种免疫网络,潜在地调节SLE复杂的免疫发病机制。SLE是一种临床和免疫异质性疾病;因此,需要精准医学来最大化JAK抑制剂的疗效。需要进一步研究以确定它们的风险效益比,并为JAK抑制剂选择最合适的患者。