Information within links.2 Mar 2025 08:12
There exists very relavent information within links.
From a previous link an extract below.
'Small molecule JAK inhibitors: is selectivity possible?
The idea of exploiting the therapeutic potential of JAK modulation was fostered by the discovery of JAK3 deficiency in patients with severe combined immune deficiency, while the later recognition of the frequent gain of function JAK2 V617F mutation in myeloproliferative disorders provided a further rationale for developing therapeutics to suppress exaggerated JAK-STAT signalling. Extensive preclinical and clinical research efforts eventually led to the development of the first JAK inhibitors, ruxolitinib and tofacitinib, which both inhibit multiple kinases although with different potencies.
Since then, a continuous strive for selectivity has characterized the development of JAK inhibitors with the overall aim of INCREASING SAFETY BY MINIMISING OFF TARGET EFFECTS WITHOUT LOSING EFFICACY. This aim is far from trivial.
First, the heterodimeric pairings and the involvement of a given JAK in several pathways complicate the selection of the best target. Even a highly JAK1 selective inhibitor will, due to the heteromeric JAK pairing, affect cytokine signalling that also depends on JAK2, JAK3, and TYK2. Further, mouse studies using both non-selective and next-generation selective JAK1-3 inhibitors demonstrate overlapping immunogenomic effects at the network level rather than blocking specific pathways. Second, the approach for all currently licensed JAK1-3 inhibitors has been to target the JH1 domain encompassing the ATP catalytic site, which is highly conserved across many kinases. Third, one such ATP competitive inhibitor will exist in equilibrium with the substrate and ATP implying that an increase in intracellular inhibitor dose, which is hard to control as it depends on patient-specific parameters such as age, sex, and co-medications, will likely affect the ATP binding to the other JAKs thereby causing loss of selectivity in vivo. Fourth, IN VIVO SELECTIVITY CANNOT DIRECTTLY BE INFERRED FROM IN VITRO STUDIES, IN VITRO AN EX VIVO DATA FROM ENZYMATIC AND BIOCHEMICAL ASSAYS VARY WIDELY ACROSS STUDIES AS THEY DEPEND ON THE SUBSTRATES CELL LINES USED,THE CYTOKINE AND OR STAT BEING MEASURED cell lines used, the cytokine and/or, and experimental dosages.Ultimately, JAK selectivity is relative, and the TRANSLATION INTO CLINICAL EFFICACY & SAFETY IS HIGHLY COMPLICATED.
Collectively, these complexities challenge the development and use of selective inhibitors yet represent a major therapeutical advantage for clinical efficacy in the treatment of complex diseases, in which multiple cytokines are typically involved, and for which the targeting of a single cytokine is likely insufficient.'
Note the 'TRANSLATION INTO CLINICAL EFFICACY & SAFETY IS HIGHLY COMPLICATED.'
Translational sudies still onging with 1802, the importance of which, attention to detail here cannot be over emphasi