Inhibition of the JAK/STAT Pathway With Baricitinib Reduces the Multiple Organ Dysfunction Caused by Hemorrhagic Shock in Rats

Ann Surg. 2023 Jul 1;278(1):e137-e146. doi: 10.1097/SLA.0000000000005571. Epub 2022 Jul 15.

Abstract

Objective: The aim of this study was to investigate (a) the effects of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway inhibitor (baricitinib) on the multiple organ dysfunction syndrome (MODS) in a rat model of hemorrhagic shock (HS) and (b) whether treatment with baricitinib attenuates the activation of JAK/STAT, NF-κB, and NLRP3 caused by HS.

Background: Posttraumatic MODS, which is in part due to excessive systemic inflammation, is associated with high morbidity and mortality. The JAK/STAT pathway is a regulator of numerous growth factor and cytokine receptors and, hence, is considered a potential master regulator of many inflammatory signaling processes. However, its role in trauma-hemorrhage is unknown.

Methods: An acute HS rat model was performed to determine the effect of baricitinib on MODS. The activation of JAK/STAT, NF-κB, and NLRP3 pathways were analyzed by western blotting in the kidney and liver.

Results: We demonstrate here for the first time that treatment with baricitinib (during resuscitation following severe hemorrhage) attenuates the organ injury and dysfunction and the activation of JAK/STAT, NF-κB, and NLRP3 pathways caused by HS in the rat.

Conclusions: Our results point to a role of the JAK/STAT pathway in the pathophysiology of the organ injury and dysfunction caused by trauma/hemorrhage and indicate that JAK inhibitors, such as baricitinib, may be repurposed for the treatment of the MODS after trauma and/or hemorrhage.

MeSH terms

  • Animals
  • Janus Kinases / metabolism
  • Janus Kinases / pharmacology
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / prevention & control
  • NF-kappa B / metabolism
  • NF-kappa B / pharmacology
  • NLR Family, Pyrin Domain-Containing 3 Protein / metabolism
  • Rats
  • STAT Transcription Factors / metabolism
  • STAT Transcription Factors / pharmacology
  • Shock, Hemorrhagic* / complications
  • Shock, Hemorrhagic* / drug therapy
  • Signal Transduction*

Substances

  • NF-kappa B
  • Janus Kinases
  • baricitinib
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • STAT Transcription Factors