مثبط الكيناز جانوس

مثبطات الكيناز جانوس (إنگليزية: Janus kinase inhibitors)، أو مثبطات JAK (إنگليزية: JAK inhibitors، أو jakinibs)،[1] هي نوع من الأدوية التي تعمل عن طريق تثبيط نشاط واحد أو أكثر من عائلة إنزيمات كيناز جانوس (JAK1، JAK2، JAK3، TYK2)، وبالتالي تتداخل مع مسار تأشير JAK-STAT.

لهذه المثبطات تطبيقات علاجية في علاج السرطان والأمراض الالتهابية[1][2] مثل التهاب المفاصل الرثياني.[3] هناك اهتمام في استخدامها لعلاج أمراض جلدية مختلفة.[4] مثبطات JAK3 هي علاج محتمل لأمراض مناعية مختلفة حيث أن وظيفتها الأساسية تقتصر الخلايا اللمفاوية. جاري العمل على تطوير مثبطات JAK3 منذ عام 2017.[5]

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آلية العمل

Janus kinase inhibitors can be classed in several overlapping classes: they are immunomodulators, they are DMARDs (disease-modifying antirheumatic drugs), and they are a subclass of tyrosine kinase inhibitors. They work by modifying the immune system via cytokine activity inhibition.

Cytokines play key roles in controlling cell growth and the immune response. Many cytokines function by binding to and activating type I and type II cytokine receptors. These receptors in turn rely on the Janus kinase (JAK) family of enzymes for signal transduction. Hence drugs that inhibit the activity of these Janus kinases block cytokine signalling.[1]

More specifically, Janus kinases phosphorylate activated cytokine receptors. These phosphorylated receptors in turn recruit STAT transcription factors which modulate gene transcription.[6]

The first JAK inhibitor to reach clinical trials was tofacitinib. Tofacitinib is a specific inhibitor of JAK3 (IC50 = 2 nM) thereby blocking the activity of IL-2, IL-4, IL-15 and IL-21. Hence Th2 cell differentiation is blocked and therefore tofacitinib is effective in treating allergic diseases. Tofacitinib to a lesser extent also inhibits JAK1 (IC50 = 100 nM) and JAK2 (IC50 = 20 nM) which in turn blocks IFN-γ and IL-6 signalling and consequently Th1 cell differentiation.[1]

One mechanism (relevant to psoriasis) is that the blocking of Jak-dependent IL-23 reduces IL-17 and the damage it causes.[4]


التصميم الجزيئي

Some JAK1 inhibitors are based on a benzimidazole core.[7]

JAK3 inhibitors target the catalytic ATP-binding site of JAK3 and various moieties have been used to get a stronger affinity and selectivity to the ATP-binding pockets. The base that is often seen in compounds with selectivity for JAK3 is pyrrolopyrimidine, as it binds to the same region of the JAKs as purine of the ATP binds.[8][9] Another ring system that has been used in JAK3 inhibitor derivatives is 1H-pyrrolo[2,3-b]pyridine, as it mimics the pyrrolopyrimidine scaffold.[10] More information on the structure activity relationship of may be found in the article on JAK3 inhibitors.

أمثلة

مركبات معتمدة

Approved by the U.S. FDA in November 2011 for myelofibrosis (intermediate- or high-risk) and polycythemia vera, in patients with an inadequate response or intolerance to hydroxyurea.[12] اعتمد روكسوليتينيب كريم (الاسم التجاري أوپزلورا) لعلاج التهاب الجلد التأتبي للأشخاص الذين يبلغون 12 عام وأكثر. كما اعتمدته منظمة الصحة العالمية لعلاج البهاق.

في التجارب السريرية

الأدوية التجريبية/دواعي الاستعمال

المصادر

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