[炎症性肠病的小分子疗法:JAK抑制剂和S1PR调节剂]。

Yu Kyung Jun, Hyuk Yoon
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引用次数: 0

摘要

小分子药物,包括 Janus 激酶(JAK)抑制剂和鞘氨醇-1-磷酸受体调节剂(S1PRMs),是治疗炎症性肠病(IBD)的前景广阔的新疗法。与生物制剂相比,小分子药物表现出更可预测的药代动力学,不太可能诱发免疫反应,而且可以口服给药。JAK 抑制剂的作用是阻断 JAK 酶的活性,从而防止信号转导和激活转录(STAT)蛋白随后发生磷酸化和激活。托法替尼(Tofacitinib)和非尔戈替尼(filgotinib)被批准用于治疗溃疡性结肠炎(UC),而乌达替尼(upadacitinib)则被批准用于治疗UC和克罗恩病。然而,JAK抑制剂会增加带状疱疹、癌症、主要不良心血管事件和静脉血栓栓塞的风险。S1PRMs 与淋巴细胞上的 S1PRs(尤其是 S1PR1)结合。这种相互作用可抑制淋巴细胞离开淋巴结并迁移到肠道,从而减轻肠道粘膜的炎症和免疫反应。奥扎莫德和依曲莫德是获准用于治疗 UC 的 S1PRM,但它们可能会导致心动过缓、传导障碍和黄斑水肿等副作用。总体而言,JAK 抑制剂和 S1PRMs 在治疗 IBD 方面具有显著疗效,但需要仔细监测其潜在的副作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Small Molecule Therapy for Inflammatory Bowel Disease: JAK Inhibitors and S1PR Modulators].

Small molecules, including Janus kinase (JAK) inhibitors and sphingosine-1-phosphate receptor modulators (S1PRMs), are promising new treatments for inflammatory bowel disease (IBD). Small molecules exhibit more predictable pharmacokinetics than biologics, are less likely to induce immune responses, and can be administered orally. JAK inhibitors function by blocking the activity of JAK enzymes, which prevents the subsequent phosphorylation and activation of signal transducer and activator of transcription (STAT) proteins. Tofacitinib and filgotinib are approved for treating ulcerative colitis (UC), while upadacitinib is approved for UC and Crohn's disease. Nevertheless, JAK inhibitors can increase the risk of herpes zoster, cancer, major adverse cardiovascular events, and venous thromboembolism. S1PRMs bind to S1PRs, particularly S1PR1, on lymphocytes. This interaction inhibits lymphocytes from exiting the lymph nodes and migrating to the gut, thereby reducing inflammation and the immune response in the intestinal mucosa. Ozanimod and etrasimod are S1PRMs approved for the treatment of UC, but they can cause side effects such as bradycardia, conduction disorder, and macular edema. Overall, JAK inhibitors and S1PRMs offer significant benefits in managing IBD, although their potential side effects require careful monitoring.

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