Su Jie, Lartey Dalia A, Zanella Gaia, Hawinkels Lukas J A C, Matteoli Gianluca, Löwenberg Mark, Barnhoorn Marieke C
Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands.
J Crohns Colitis. 2025 Jun 4;19(6). doi: 10.1093/ecco-jcc/jjaf087.
Intestinal fibrosis in inflammatory bowel disease (IBD) is caused by uncontrolled accumulation of extracellular matrix deposited by fibroblasts. This may result in stricture formation, especially in Crohn's disease. Since there are no anti-fibrotic drugs available, endoscopic or surgical interventions are the only options to treat intestinal strictures. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway plays a crucial role in intestinal homeostasis and inflammation. JAK inhibition represents a relatively novel therapeutic strategy in IBD by simultaneously blocking multiple cytokines across various inflammatory pathways. Interestingly, JAK inhibitors extend their benefits beyond anti-inflammatory effects, as they have been shown to interfere with fibrotic processes in various diseases, including IBD. We here summarize the current understanding of the role of the JAK-STAT pathway in the pathogenesis of intestinal fibrosis and the application of JAK inhibitors for IBD. In addition, we discuss the use of JAK inhibitors in other fibrotic-related diseases to postulate how these agents might be applied for future treatment of intestinal fibrosis.
炎症性肠病(IBD)中的肠道纤维化是由成纤维细胞沉积的细胞外基质不受控制地积累所致。这可能导致狭窄形成,尤其是在克罗恩病中。由于目前尚无抗纤维化药物,内镜或手术干预是治疗肠道狭窄的唯一选择。 Janus激酶-信号转导子和转录激活子(JAK-STAT)通路在肠道稳态和炎症中起关键作用。JAK抑制通过同时阻断各种炎症途径中的多种细胞因子,代表了IBD中一种相对新颖的治疗策略。有趣的是,JAK抑制剂的益处不仅限于抗炎作用,因为它们已被证明可干扰包括IBD在内的各种疾病中的纤维化过程。我们在此总结了目前对JAK-STAT通路在肠道纤维化发病机制中的作用以及JAK抑制剂在IBD中的应用的理解。此外,我们讨论了JAK抑制剂在其他纤维化相关疾病中的使用,以推测这些药物未来如何应用于肠道纤维化的治疗。