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Role of JAK-STAT signaling pathway in pathogenesis and treatment of primary Sjögren’s syndrome

中华医学杂志（英文版） 2023年第19期136卷 2297-2306页

作者： Mucong Li Mengtao Li Lin Qiao Chanyuan Wu Dong Xu Yan Zhao Xiaofeng Zeng China 100730

Primary Sjögren’s syndrome (pSS) is a systemic autoimmune disease with high prevalence and possible poor prognosis. Though the pathogenesis of pSS has not been fully elucidated, B cell hyperactivity is considered as one of the fundamental abnormalities in pSS patients. It has long been identified that Janus kinases-signal transducer and activator of transcription (JAK-STAT) signaling pathway contributes to rheumatoid arthritis and systemic lupus erythematosus. Recently, increasing numbers of studies have provided evidence that JAK-STAT pathway also has an important role in the pathogenesis of pSS via direct or indirect activation of B cells. Signal transducer and activator of transcription 1 (STAT1), STAT3, and STAT5 activated by various cytokines and ribonucleic acid contribute to pSS development, respectively or synergically. These results reveal the potential application of Janus kinase inhibitors for treatment of pSS, which may fundamentally improve the quality of life and prognosis of patients with pSS.

关键词： Primary Sjögren’s syndrome JAK-STAT pathway Janus kinase inhibitors disease-modifying antirheumatic drugs

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Hepatitis B virus reactivation in rheumatoid arthritis

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World Journal of Clinical Cases 2022年第1期10卷 12-22页

作者： Ya-Li Wu Jing Ke Bao-Yu Zhang Dong Zhao Center for Endocrine Metabolism and Immune diseases Beijing Luhe HospitalCapital Medical UniversityBeijing 101149China

Rheumatoid arthritis(RA)is an autoimmune disease characterized by proliferative synovitis,which can cause cartilage and bone damage as well as functional ***-modifying anti-rheumatic drugs have significantly improved the prognosis of RA ***,people with RA,when combined with hepatitis B virus(HBV)infection,may experience reactivation of HBV during treatment with anti-rheumatic *** outcome of HBV reactivation(HBVr)varies from liver inflammation to liver failure,while insufficient HBV screening in RA patients has been reported in various ***,it is necessary to identify patients at high risk before starting immunosuppressive *** immune response plays an important role in anti-HBV ***,most anti-rheumatic drugs exert an inhibitory effect on the body’s immune system,resulting in ***,it is necessary to conduct a comprehensive evaluation based on host factors,viral factors,and drug *** this paper,we summarize the mechanism of HBVr,the risk of HBVr caused by anti-rheumatic drugs,and the appropriate diagnosis and treatment process for RA patients so that clinicians can have a more comprehensive understanding of HBVr in RA patients.

关键词： Rheumatoid arthritis Hepatitis B virus reactivation disease-modifying antirheumatic drugs Risk factors

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Hepatitis B virus infection reactivation in patients under immunosuppressive therapies:Pathogenesis,screening,prevention and treatment

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World Journal of Virology 2022年第5期11卷 275-282页

作者： Anna Maria Spera Infectious disease Unit Universitary Hospital OORR San Giovanni di Dio e Ruggi d'AragonaSalerno 84131Italy

With a 5.3%of the global population involved,hepatitis B virus(HBV)is a major public health challenge requiring an urgent *** a possible acute phase,the natural history of HBV infection can progress in *** with overt or occult HBV infection can undergo HBV reactivation(HBVr)in course of immunosuppressive treatments that,apart from oncological and hematological diseases,are also used in rheumatologic,gastrointestinal,neurological and dermatological settings,as well as to treat severe acute respiratory syndrome coronavirus 2 *** risk of HBV reactivation is related to the immune status of the patient and the baseline HBV infection *** aim of the present paper is to investigate the risk of HBVr in those not oncological settings in order to suggest strategies for preventing and treating this *** main studies about HBVr for patients with occult hepatitis B infection and chronic HBV infection affected by non-oncologic diseases eligible for immunosuppressive treatment have been *** occurrence of this challenging event can be reduced screening the population eligible for immunosuppressant to assess the best strategies according to any virological *** prospective studies are needed to increase data on the risk of HBVr related to newer immunomodulant agents employed in non-oncological setting.

关键词： Hepatitis B Virus infection Reactivation Occult B infection Chronic B infection Immunosuppression disease-modifying antirheumatic drugs

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Treatment Adherence of Patients with Rheumatoid Arthritis during COVID-19 Pandemic

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Open Journal of Rheumatology and Autoimmune diseases 2021年第3期11卷 106-114页

作者： Syamasis Bandyopadhyay Susobhan Mondal Apollo Gleneagles Hospital Kolkata India

India is no exception to the economic setback due to coronavirus disease 2019 (COVID-19). Loss of jobs and income dramatically impacts the health care cost of chronic disease management. Rheumatoid arthritis is a chronic condition with a high-cost implication. With the outbreak of COVID-19, there is uncertainty about continuing immunosuppressive therapy for rheumatoid arthritis for several reasons. In this milieu, we undertook a prospective observational study to observe the use of Janus Kinase (JAK) inhibitors in a hospital-based rheumatology service in Eastern India during the pandemic period (21 March 2020 to 31 July 2020). Forty-two patients with rheumatoid arthritis were receiving treatment with JAK inhibitors. Twenty-four patients visited the Outpatient Department (OPD) during the COVID-19 pandemic. All of them were COVID-negative, but few of the patients had influenza-like symptoms. Patients faced up to a 25% reduction in their annual income during the COVID-19 pandemic. Of 24 patients, four patients had stopped treatment with JAK inhibitors owing to financial constraints or initial non-availability of medications during the lockdown. In this study, adherence to JAK inhibitors was substantially high even in the face of income curtailment during the COVID-19 pandemic.

关键词： COVID-19 Rheumatoid Arthritis Janus Kinase JAK Inhibitors disease-modifying antirheumatic drugs Adherence Cost

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