Targeting JAK/STAT pathway in Takayasu's arteritis

Ann Rheum Dis. 2020 Jul;79(7):951-959. doi: 10.1136/annrheumdis-2019-216900. Epub 2020 Mar 25.

Abstract

Objective: Takayasu's arteritis (TAK) is a large vessel vasculitis with important infiltration of proinflammatory T cells in the aorta and its main branches, but its aetiology is still unknown. Our work aims to explore the involvement of Janus Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) signalling pathway in proinflammatory T cells differentiation and disease activity of TAK.

Methods: We analysed transcriptome and interferons gene signatures of fluorescence-activated cell sorting (FACS-sorted) CD4+ and CD8+ T cells from healthy donors (HD) and in 25 TAK (median age of 37.6 years including 21 active TAK with National Institutes of Health (NIH) score >1). Then we tested, in vitro and in vivo, the effects of JAK inhibitors (JAKinibs) in TAK.

Results: Transcriptome analysis showed 248 and 432 significantly dysregulated genes for CD4+ and CD8+ samples between HD and TAK, respectively. Among dysregulated genes, we highlighted a great enrichment for pathways linked to type I and type II interferons, JAK/STAT and cytokines/chemokines-related signalling in TAK. We confirmed by Real Time Reverse Transcription Polymerase Chain Reaction (RT-qPCR) the upregulation of type I interferons gene signature in TAK as compared with HD. JAKinibs induced both in vitro and in vivo a significant reduction of CD25 expression by CD4+ and CD8+ T cells, a significant decrease of type 1 helper T cells (Th1) and Th17 cells and an increase of Tregs cells in TAK. JAKinibs also decreased C reactive protein level, NIH score and corticosteroid dose in TAK patients.

Conclusions: JAK/STAT signalling pathway is critical in the pathogenesis of TAK and JAKinibs may be a promising therapy.

Keywords: T cells; chemokines; cytokines; inflammation; systemic vasculitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Interferons
  • Janus Kinase Inhibitors / pharmacology*
  • Janus Kinases / metabolism*
  • Lymphocyte Activation / drug effects
  • MAP Kinase Signaling System / genetics*
  • Male
  • Middle Aged
  • STAT Transcription Factors / metabolism*
  • Takayasu Arteritis / drug therapy
  • Takayasu Arteritis / genetics*
  • Th1 Cells
  • Th17 Cells

Substances

  • Janus Kinase Inhibitors
  • STAT Transcription Factors
  • Interferons
  • Janus Kinases