Zhang Yuanteng, Gao Zizheng, Jiang Feng, Yan Hao, Yang Bo, He Qiaojun, Luo Peihua, Xu Zhifei, Yang Xiaochun
Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, China; Institute of Drug Discovery and Design, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, China.
Center for Drug Safety Evaluation and Research of Zhejiang University, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, Zhejiang, China.
Biochem Pharmacol. 2023 Feb;208:115382. doi: 10.1016/j.bcp.2022.115382. Epub 2022 Dec 14.
Acute respiratory distress syndrome (ARDS) is characterized by noncardiogenic pulmonary edema. It has a high mortality rate and lacks effective pharmacotherapy. With the outbreak of COVID-19 worldwide, the mortality of ARDS has increased correspondingly, which makes it urgent to find effective targets and strategies for the treatment of ARDS. Recent clinical trials of Janus kinase (JAK) inhibitors in treating COVID-19-induced ARDS have shown a positive outcome, which makes the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway a potential therapeutic target for treating ARDS. Here, we review the complex cause of ARDS, the molecular JAK/STAT pathway involved in ARDS pathology, and the progress that has been made in strategies targeting JAK/STAT to treat ARDS. Specifically, JAK/STAT signaling directly participates in the progression of ARDS or colludes with other pathways to aggravate ARDS. We summarize JAK and STAT inhibitors with ARDS treatment benefits, including inhibitors in clinical trials and preclinical studies and natural products, and discuss the side effects of the current JAK inhibitors to reveal future trends in the design of JAK inhibitors, which will help to develop effective treatment strategies for ARDS in the future.
急性呼吸窘迫综合征(ARDS)的特征是非心源性肺水肿。它具有高死亡率且缺乏有效的药物治疗方法。随着新冠病毒(COVID-19)在全球范围内的爆发,ARDS的死亡率相应增加,这使得寻找有效的ARDS治疗靶点和策略变得迫在眉睫。近期关于Janus激酶(JAK)抑制剂治疗COVID-19诱导的ARDS的临床试验显示出积极结果,这使得Janus激酶/信号转导及转录激活因子(JAK/STAT)通路成为治疗ARDS的潜在靶点。在此,我们综述ARDS的复杂病因、参与ARDS病理过程的分子JAK/STAT通路,以及靶向JAK/STAT治疗ARDS的策略进展。具体而言,JAK/STAT信号直接参与ARDS的进展或与其他通路共同作用加重ARDS。我们总结了对ARDS治疗有益的JAK和STAT抑制剂,包括临床试验和临床前研究中的抑制剂以及天然产物,并讨论了当前JAK抑制剂的副作用,以揭示JAK抑制剂设计的未来趋势,这将有助于未来开发有效的ARDS治疗策略。