William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Department of Neurosciences "Rita Levi Montalcini," University of Turin, Turin, Italy.
Ann Surg. 2023 Jul 1;278(1):e137-e146. doi: 10.1097/SLA.0000000000005571. Epub 2022 Jul 15.
OBJECTIVE: The aim of this study was to investigate (a) the effects of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway inhibitor (baricitinib) on the multiple organ dysfunction syndrome (MODS) in a rat model of hemorrhagic shock (HS) and (b) whether treatment with baricitinib attenuates the activation of JAK/STAT, NF-κB, and NLRP3 caused by HS. BACKGROUND: Posttraumatic MODS, which is in part due to excessive systemic inflammation, is associated with high morbidity and mortality. The JAK/STAT pathway is a regulator of numerous growth factor and cytokine receptors and, hence, is considered a potential master regulator of many inflammatory signaling processes. However, its role in trauma-hemorrhage is unknown. METHODS: An acute HS rat model was performed to determine the effect of baricitinib on MODS. The activation of JAK/STAT, NF-κB, and NLRP3 pathways were analyzed by western blotting in the kidney and liver. RESULTS: We demonstrate here for the first time that treatment with baricitinib (during resuscitation following severe hemorrhage) attenuates the organ injury and dysfunction and the activation of JAK/STAT, NF-κB, and NLRP3 pathways caused by HS in the rat. CONCLUSIONS: Our results point to a role of the JAK/STAT pathway in the pathophysiology of the organ injury and dysfunction caused by trauma/hemorrhage and indicate that JAK inhibitors, such as baricitinib, may be repurposed for the treatment of the MODS after trauma and/or hemorrhage.
目的:本研究旨在探讨(a)Janus 激酶(JAK)/信号转导和转录激活因子(STAT)通路抑制剂(巴瑞替尼)对失血性休克(HS)大鼠模型多器官功能障碍综合征(MODS)的影响,以及(b)巴瑞替尼是否能减轻 HS 引起的 JAK/STAT、NF-κB 和 NLRP3 的激活。
背景:创伤后 MODS 部分是由于过度的全身炎症引起的,与高发病率和死亡率相关。JAK/STAT 通路是许多生长因子和细胞因子受体的调节剂,因此被认为是许多炎症信号转导过程的潜在主调节剂。然而,其在创伤性出血中的作用尚不清楚。
方法:采用急性 HS 大鼠模型,观察巴瑞替尼对 MODS 的影响。通过 Western blot 分析肾和肝中 JAK/STAT、NF-κB 和 NLRP3 通路的激活。
结果:我们首次证明,巴瑞替尼(在严重出血后复苏期间)治疗可减轻 HS 引起的大鼠器官损伤和功能障碍以及 JAK/STAT、NF-κB 和 NLRP3 通路的激活。
结论:我们的研究结果表明 JAK/STAT 通路在创伤/出血引起的器官损伤和功能障碍的病理生理学中发挥作用,并表明 JAK 抑制剂,如巴瑞替尼,可能被重新用于治疗创伤和/或出血后的 MODS。
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