1型糖尿病和免疫检查点相关糖尿病中的Janus激酶及信号转导和转录激活因子抑制剂:现状与未来展望

Janus kinase and signal transducer and activator of transcription inhibitors in type 1 diabetes and immune checkpoint-related diabetes: current status and future perspectives.

作者信息

Su Bowei, Luan Zhi-Lin, Liu Haixia, Tuomilehto Jaakko, Ji Xiaochen

机构信息

Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Dalian Medical University, Dalian, China.

Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, China.

出版信息

Front Immunol. 2025 Jun 4;16:1571247. doi: 10.3389/fimmu.2025.1571247. eCollection 2025.

Abstract

Type 1 diabetes (T1D) is an autoimmune-mediated disorder that leads to the destruction of pancreatic beta-cells, insulin deficiency, and chronic hyperglycemia. It is one of the most common childhood endocrine disorders. Recent evidence indicates that aberrant Janus kinase-signal transducer and activator of transcription (JAK/STAT) signaling exacerbates T1D by promoting the production of proinflammatory cytokines and chemokines. By blocking JAK-mediated phosphorylation of STAT proteins, JAK inhibitors help alleviate cytokine-driven inflammation, reduce insulin requirements, and relieve complications such as painful peripheral neuropathy, potentially preserving residual beta-cell function and improving glycemic control. Moreover, emerging data underscore the potential synergy between JAK inhibitors and immune checkpoint therapies targeting the programmed cell death protein 1 (PD-1) pathway, as PD-1/Programmed cell death ligand 1 (PD-L1) inhibitors used in antitumor therapy can induce immune checkpoint inhibitor-induced diabetes (CPI-DM). This review examines the impact of JAK inhibitors on beta-cells and immune cells in T1D, along with their safety profiles and adverse effects. It explores the potential benefits and risks of combining JAK inhibitors in the management of CPI-DM associated with anti-PD-1/PD-L1 therapy. In conclusion, while JAK inhibitors have demonstrated the potential to reduce inflammation and preserve beta-cell function in preclinical studies, further clinical trials are needed to confirm their long-term safety and efficacy in patients with T1D and CPI-DM.

摘要

1型糖尿病(T1D)是一种自身免疫介导的疾病,可导致胰腺β细胞破坏、胰岛素缺乏和慢性高血糖。它是儿童期最常见的内分泌疾病之一。最近的证据表明,异常的Janus激酶-信号转导子和转录激活子(JAK/STAT)信号通过促进促炎细胞因子和趋化因子的产生而加重T1D。通过阻断JAK介导的STAT蛋白磷酸化,JAK抑制剂有助于减轻细胞因子驱动的炎症,降低胰岛素需求,并缓解诸如疼痛性周围神经病变等并发症,有可能保留残余β细胞功能并改善血糖控制。此外,新出现的数据强调了JAK抑制剂与靶向程序性细胞死亡蛋白1(PD-1)途径的免疫检查点疗法之间的潜在协同作用,因为用于抗肿瘤治疗的PD-1/程序性细胞死亡配体1(PD-L1)抑制剂可诱发免疫检查点抑制剂诱导的糖尿病(CPI-DM)。本综述探讨了JAK抑制剂对T1D中β细胞和免疫细胞的影响,以及它们的安全性和不良反应。它探讨了在与抗PD-1/PD-L1治疗相关的CPI-DM管理中联合使用JAK抑制剂的潜在益处和风险。总之,虽然JAK抑制剂在临床前研究中已显示出减轻炎症和保留β细胞功能的潜力,但仍需要进一步的临床试验来确认它们在T1D和CPI-DM患者中的长期安全性和疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1480/12174428/5b2c25ba54ac/fimmu-16-1571247-g001.jpg

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