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The JAK-STAT pathway: an emerging target for cardiovascular disease in rheumatoid arthritis and myeloproliferative

Chiara Baldini1, Francesca Romana Moriconi1,2, Sara Galimberti3

  • 1Division of Rheumatology, University of Pisa and Pisa University Hospital, Via Paradisa, 2, Pisa 56124, Italy.

European Heart Journal
|August 3, 2021
PubMed

Insights

The JAK-STAT pathway is implicated in rheumatoid arthritis and myeloproliferative neoplasms, increasing cardiovascular risk. Inhibitors may reduce cardiovascular events but require further study for safety, especially regarding prothrombotic effects.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Oncology

Background:

  • Inflammation is a key factor in cardiovascular diseases (CVD).
  • The Janus kinase-STAT (JAK-STAT) signaling pathway is crucial in inflammatory conditions like rheumatoid arthritis (RA) and chronic myeloproliferative neoplasms (MPNs), which are associated with increased CVD risk.

Purpose of the Study:

  • To review the literature on JAK-STAT pathway dysregulation in RA/MPNs and its link to cardiovascular risk.
  • To examine the potential cardiovascular effects of JAK-STAT inhibitors.

Main Methods:

  • Literature review of international studies.
  • Analysis of the role of the JAK-STAT pathway in inflammatory and thrombotic processes.
  • Evaluation of cytokine profiles (IL-6, IL-1-β, TNF-α, IL-10) and platelet protein expression (PKCε).

Main Results:

  • The JAK-STAT pathway promotes inflammation and thrombosis in RA and MPNs.
  • Imbalances in pro-inflammatory cytokines and prothrombotic factors are observed.
  • The JAK-STAT pathway is also involved in atherosclerotic cardiovascular disease.

Conclusions:

  • JAK-STAT inhibitors show potential for reducing cardiovascular events in RA/MPNs patients.
  • Further research is needed to assess the cardiovascular safety of JAK-STAT inhibitors, particularly concerning prothrombotic risks.
  • Careful evaluation of benefits and risks is essential before considering JAK-STAT inhibitors for managing cardiovascular risk in these patient populations.

Keywords:
AtherosclerosisBaricitinibCardiovascular diseaseInflammationJAK–STAT pathwayMyeloproliferative neoplasmRheumatoid arthritisRuxolitinibTofacitinib

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