Efficacy of JAK1/2 inhibition in murine immune bone marrow failure

Blood. 2023 Jan 5;141(1):72-89. doi: 10.1182/blood.2022015898.

Abstract

Immune aplastic anemia (AA) is a severe blood disease characterized by T-lymphocyte- mediated stem cell destruction. Hematopoietic stem cell transplantation and immunosuppression are effective, but they entail costs and risks, and are not always successful. The Janus kinase (JAK) 1/2 inhibitor ruxolitinib (RUX) suppresses cytotoxic T-cell activation and inhibits cytokine production in models of graft-versus-host disease. We tested RUX in murine immune AA for potential therapeutic benefit. After infusion of lymph node (LN) cells mismatched at the major histocompatibility complex [C67BL/6 (B6)⇒CByB6F1], RUX, administered as a food additive (Rux-chow), attenuated bone marrow hypoplasia, ameliorated peripheral blood pancytopenia, preserved hematopoietic progenitors, and prevented mortality, when used either prophylactically or therapeutically. RUX suppressed the infiltration, proliferation, and activation of effector T cells in the bone marrow and mitigated Fas-mediated apoptotic destruction of target hematopoietic cells. Similar effects were obtained when Rux-chow was fed to C.B10 mice in a minor histocompatibility antigen mismatched (B6⇒C.B10) AA model. RUX only modestly suppressed lymphoid and erythroid hematopoiesis in normal and irradiated CByB6F1 mice. Our data support clinical trials of JAK/STAT inhibitors in human AA and other immune bone marrow failure syndromes.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Anemia, Aplastic* / pathology
  • Animals
  • Bone Marrow / pathology
  • Bone Marrow Diseases* / pathology
  • Bone Marrow Failure Disorders / pathology
  • Humans
  • Janus Kinase 1
  • Mice
  • Pancytopenia* / pathology

Substances

  • JAK1 protein, human
  • Janus Kinase 1