JAK inhibitors in atopic dermatitis

Abstract

Atopic dermatitis (AD) is a chronic, heterogeneous, inflammatory, pruritic skin disorder. It’s pathomechanism is complex, involves the skin barrier, immunological and genetic factors. Onset can occur at any age but most common in the first year of life. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is of paramount importance in mediating signalling by cytokines of major importance in the immunopathogenesis of AD, such as IL-4, IL-5, IL-13, IL-31, thymic stromal lymphopoietin (TSLP), and in mediating skin barrier function and pruritus. This central role explains why several signalling pathways being important in the development and maintenance of AD can be blocked by inhibition of the
JAK-STAT pathway. As a result, inflammation and pruritus are reduced within days, leading to a significant improvement in patients' quality of life. In the present article, the currently used JAK inhibitors in Hungary for the treatment of atopic dermatitis are presented, with focus on the pathomechanism of the disease.