The rationale for targeting the JAK/STAT pathway in scleroderma-associated interstitial lung disease

Immunotherapy. 2021 Feb;13(3):241-256. doi: 10.2217/imt-2020-0270. Epub 2020 Dec 2.

Abstract

The etiopathogenesis of systemic sclerosis (SSc)-associated interstitial lung disease (ILD) is still debated and no therapeutic options have proved fully effective to date. The intracellular Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway is highly conserved among either immune or nonimmune cells and involved in inflammation and fibrosis. Evidence from preclinical studies shows that the JAK/STAT signaling cascade has a crucial role in the differentiation of autoreactive cells as well as in the extracellular matrix remodeling that occurs in SSc. Therefore, it is likely that the use of oral small molecule JAK-inhibitors, especially if prescribed early, may prevent or slow the progression of SSc-associated ILD, but few clinical studies currently support this hypothesis.

Keywords: JAK-inhibitors; JAK/STAT pathway; interstitial lung disease; lung fibrosis; oral small molecules; scleroderma; signaling pathways; systemic sclerosis.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Inflammation
  • Janus Kinase Inhibitors / pharmacology
  • Janus Kinase Inhibitors / therapeutic use*
  • Janus Kinases / metabolism
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / etiology
  • Lung Diseases, Interstitial / metabolism
  • Lung Diseases, Interstitial / pathology
  • Pulmonary Fibrosis
  • STAT Transcription Factors / metabolism
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / drug therapy*
  • Scleroderma, Systemic / metabolism
  • Scleroderma, Systemic / pathology
  • Signal Transduction / drug effects*

Substances

  • Janus Kinase Inhibitors
  • STAT Transcription Factors
  • Janus Kinases