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JAK抑制剂在系统性硬化症相关间质性肺病治疗中的潜在作用:从发病机制到实际临床数据的叙述性综述

Potential Role of JAK Inhibitors in the Treatment of Systemic Sclerosis-Associated Interstitial Lung Disease: A Narrative Review from Pathogenesis to Real-Life Data.

作者信息

Fiorentini Elisa, Bonomi Francesco, Peretti Silvia, Orlandi Martina, Lepri Gemma, Matucci Cerinic Marco, Bellando Randone Silvia, Guiducci Serena

机构信息

Department of Clinical and Experimental Medicine, University of Florence, 50134 Florence, Italy.

Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, 20132 Milan, Italy.

出版信息

Life (Basel). 2022 Dec 14;12(12):2101. doi: 10.3390/life12122101.

Abstract

BACKGROUND

Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is one of the most relevant complications of SSc and the major cause of death. The pathogenesis of SSc-ILD involves a complex interplay of multiple cell types and different molecular pathways, with both inflammation and fibrosis as pathological hallmarks. To date, there are no treatments able to target both components of the disease. Janus kinase inhibitors (JAKinibs) represent an interesting therapeutic option because they exert both anti-inflammatory and anti-fibrotic properties.

METHODS

Here, we performed a narrative review concerning the potential role of JAKinibs in SSc-ILD to define the state of art and to evaluate the pathogenetic rationale behind this type of treatment.

RESULTS

Currently, few studies investigated SSc-ILD response to JAKinibs treatment. Data were analyzed from three clinical studies and four case reports and progression of SSc-ILD was not evident in 93.5% of patients treated with JAKinibs.

CONCLUSIONS

Available evidence of efficacy of JAKinibs in SSc-ILD is sparse but promising. JAKinibs could be an interesting treatment in SSc-ILD because of their potential inhibition of the fibrotic processes combined with their anti-inflammatory action. Moreover, JAKinibs were also shown in some studies to have a potential effect on pulmonary arterial hypertension (PAH), another threatening complication in SSc. More data are necessary to define JAKinibs role in SSc-ILD treatment.

摘要

背景

系统性硬化症相关间质性肺疾病(SSc-ILD)是系统性硬化症最相关的并发症之一,也是主要死因。SSc-ILD的发病机制涉及多种细胞类型和不同分子途径的复杂相互作用,炎症和纤维化均为病理特征。迄今为止,尚无能够针对该疾病这两个组成部分的治疗方法。Janus激酶抑制剂(JAKinibs)是一种有前景的治疗选择,因为它们具有抗炎和抗纤维化特性。

方法

在此,我们对JAKinibs在SSc-ILD中的潜在作用进行了叙述性综述,以确定当前的研究现状,并评估这类治疗背后的发病学原理。

结果

目前,很少有研究调查SSc-ILD对JAKinibs治疗的反应。对三项临床研究和四份病例报告的数据进行了分析,结果显示,接受JAKinibs治疗的患者中,93.5%的患者SSc-ILD病情未出现进展。

结论

JAKinibs在SSc-ILD中有效的现有证据虽少,但很有前景。JAKinibs可能是SSc-ILD的一种有吸引力的治疗方法,因为它们有可能抑制纤维化过程并兼具抗炎作用。此外,一些研究还表明JAKinibs对肺动脉高压(PAH)可能有作用,PAH是SSc中另一种具有威胁性的并发症。需要更多数据来确定JAKinibs在SSc-ILD治疗中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7396/9785277/94309cb9c479/life-12-02101-g001.jpg

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