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A Comprehensive Literature Review of JAK Inhibitors in Treatment of Alopecia Areata

机译:jak抑制剂治疗Alopecia Areata的综合文献综述

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摘要

Alopecia areata (AA) is a chronic, immune-mediated form of nonscarring alopecia that is multifactorial and results in localized patches. It is often described as a self-limiting condition that results in the spontaneous regrowth of hair in most cases. However, this regrowth may take several months or years to occur in some patients, leading to the development of psychoemotional trauma in those that are affected. Although several therapies for AA have been developed and tested, there is no specific treatment that has been approved, leading to the availability of many off-label conventional treatment options, with very limited responses. More recently, with the advancement of pre-clinical and genetic studies, a greater understanding of the pathomechanisms involved in the development of AA has been uncovered. This has resulted in the introduction of targeted therapies that use small molecules to block specific pathways involved in AA pathophysiology. As such, the use of janus kinase (JAK) inhibitors for treatment of AA has emerged. JAK inhibitors block the T-cell mediated inflammatory response thought to be the driving factor behind AA pathogenesis, by inhibiting the janus kinase (JAK) signal transducer and activator of transcription (STAT) signaling pathway, leading to a reversal of hair loss in AA patients. Thus, in an effort to demonstrate the efficacy of JAK inhibitors in the treatment of AA, several studies have been published within recent years. However, the question remains, “Are JAK inhibitors effective and safe in the management of Alopecia Areata?”. This review aims to provide a comprehensive report on the role, efficacy, and outcomes of using JAK inhibitors in the treatment of AA. To competently answer the research question highlighted, the most recent, quality articles published over a 10–15-year period were sourced using PubMed, NCBI, Research gate, Medline, Cochrane Central Register of Controlled Trials, EMBASE and Google scholar. The literature search was primarily focused on randomized controlled trials (RCTs); however, in the absence of such, only the most recently published case reports, case series, clinical trials and open-label studies published to date were included.
机译:Alopecia Areata(AA)是一种慢性免疫介导的非传动血管癌的形式,是多因素,并导致局部斑块。它通常被描述为自我限制的条件,导致大多数情况下发芽的自发再生。然而,这种再生可能需要几个月或多年的时间才能发生在一些患者中,从而导致受影响的人的心理间隙的发展。尽管已经开发并测试了几种AA疗法,但没有批准的具体治疗,导致许多非标签常规治疗方案的可用性,具有非常有限的反应。更近来,随着临床前和遗传研究的进步,更加了解参与AA发展的土地机制的理解已经被发现。这导致引入使用小分子来阻止参与AA病理生理学的特异性途径的靶向疗法。因此,出现了使用Janus激酶(Jak)抑制剂治疗AA。 Jak抑制剂阻断T细胞介导的炎症反应被认为是AA发病机制背后的驱动因子,通过抑制Janus激酶(Jak)信号传感器和转录(统计)信号传导途径的活化剂,导致AA患者的脱发逆转。因此,为了证明JAK抑制剂在治疗AA治疗中的疗效,近年来已经发表了几项研究。然而,问题仍然存在,“jak抑制剂有效和安全地在秃鹰管理中的管理?”。本综述旨在提供关于使用JAK抑制剂治疗AA的角色,疗效和结果的全面报告。为了掌握突出的研究问题,最近发表的最新品质文章在10-15年期间出版的是使用PubMed,NCBI,研究门,MEDLINE,Cochrane中央登记册,EMPASE和Google Scholar来源。文献搜索主要集中在随机对照试验(RCT);但是,在没有此类的情况下,包括最近发表的案例报告,案例系列,临床试验和迄今为止发布的开放标签研究。

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