Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
Juvenile Myositis Pathogenesis and Therapeutics Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
Nat Rev Immunol. 2023 Dec;23(12):787-806. doi: 10.1038/s41577-023-00877-7. Epub 2023 May 15.
Protein kinases play a major role in cellular activation processes, including signal transduction by diverse immunoreceptors. Given their roles in cell growth and death and in the production of inflammatory mediators, targeting kinases has proven to be an effective treatment strategy, initially as anticancer therapies, but shortly thereafter in immune-mediated diseases. Herein, we provide an overview of the status of small molecule inhibitors specifically generated to target protein kinases relevant to immune cell function, with an emphasis on those approved for the treatment of immune-mediated diseases. The development of inhibitors of Janus kinases that target cytokine receptor signalling has been a particularly active area, with Janus kinase inhibitors being approved for the treatment of multiple autoimmune and allergic diseases as well as COVID-19. In addition, TEC family kinase inhibitors (including Bruton's tyrosine kinase inhibitors) targeting antigen receptor signalling have been approved for haematological malignancies and graft versus host disease. This experience provides multiple important lessons regarding the importance (or not) of selectivity and the limits to which genetic information informs efficacy and safety. Many new agents are being generated, along with new approaches for targeting kinases.
蛋白激酶在细胞激活过程中发挥主要作用,包括各种免疫受体的信号转导。鉴于它们在细胞生长和死亡以及炎症介质产生中的作用,针对激酶已被证明是一种有效的治疗策略,最初是作为抗癌疗法,但此后不久就在免疫介导的疾病中得到应用。本文概述了专门针对与免疫细胞功能相关的蛋白激酶生成的小分子抑制剂的现状,重点介绍了那些已批准用于治疗免疫介导性疾病的抑制剂。靶向细胞因子受体信号的 Janus 激酶抑制剂的开发是一个特别活跃的领域,Janus 激酶抑制剂已被批准用于治疗多种自身免疫和过敏性疾病以及 COVID-19。此外,针对抗原受体信号的 Tec 家族激酶抑制剂(包括布鲁顿酪氨酸激酶抑制剂)已被批准用于血液系统恶性肿瘤和移植物抗宿主病。这一经验为选择性的重要性(或不重要性)以及遗传信息对疗效和安全性的影响程度提供了多个重要的经验教训。许多新的药物正在生成,同时也有针对激酶的新方法。