JAK inhibitors for asthma - 05/10/21
, Patrick Donohue, MD b, Margaret Connolly, MD a, Michael E. Wechsler, MD bAbstract |
Asthma is an inflammatory disease of the airways characterized by intermittent episodes of wheezing, chest tightness, and cough. Many of the inflammatory pathways implicated in asthma involve cytokines and growth factors that activate Janus kinases (JAKs). The discovery of the JAK/signal transducer and activator of transcription (STAT) signaling pathway was a major breakthrough that revolutionized our understanding of cell growth and differentiation. JAK inhibitors are under active investigation for immune and inflammatory diseases, and they have demonstrated clinical efficacy in diseases such as rheumatoid arthritis and atopic dermatitis. Substantial preclinical data support the idea that inhibiting JAKs will ameliorate airway inflammation and hyperreactivity in asthma. Here, we review the rationale for use of JAK inhibitors in different asthma endotypes as well as the preclinical and early clinical evidence supporting such use. We review preclinical data from the use of systemic and inhaled JAK inhibitors in animal models of asthma and safety data based on the use of JAK inhibitors in other diseases. We conclude that JAK inhibitors have the potential to usher in a new era of anti-inflammatory treatment for asthma.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, severe asthma, Janus kinase, JAK/STAT pathway, JAK Inhibitor
Abbreviations used : AHR, ASM, BAL, DMARD, EPO, FDA, Feno, IC50, ICS, ILC2, iNOS, JAK, Ki, OVA, RA, STAT, Treg, TSLP, VTE
Plan
| S.N.G. was supported by grants from the NIH including R01 AI144241 and U24 HL138998. P.D. and M.C. were supported by NIH T32 HL066988. M.E.W. was supported by NIH UG1 HL139123 and the Jin Hua Foundation. The authors gratefully acknowledge helpful discussion with the PrecISE Asthma Network Jak Inhibitor Working Group (Praveen Akuthota, Anastasia Ivanova, Jonathan M. Gaffin, James Moy, Sally J. Wenzel). |
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| Disclosure of potential conflict of interest: S. N. Georas reports receiving grants from the National Institutes of Health for asthma research and personal fees from Merck outside the submitted work; his spouse reports grants and personal fees from AbbVie, Allakos, AstraZeneca, Benevolent AIBio, DermTech, Galderma, Incyte, Janssen, Kiniksa, LEO Pharma, Lilly, Novartis, Pfizer, Principia Biopharma, Rapt Therapeutics, Regeneron, Sanofi/Genzyme, Sanofi-Aventis, and Stealth Biotherapeutics, for the design and conduct of clinical trials in atopic dermatitis, including some with JAK inhibitors. M. E. Wechsler reports consulting honoraria/fees from GlaxoSmithKline, AstraZeneca, Sanofi, Regeneron, Boehringer Ingelheim, Teva, Sentien, Cohero, Genzyme, Novartis, Genentech, Restorbio, and Equillium outside of the submitted work. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 148 - N° 4
P. 953-963 - octobre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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