Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways
Objective To characterise the molecular pathways impacted by the pharmacologic effects of the Janus kinase (JAK) 1 and JAK2 inhibitor baricitinib in SLE.Methods In a phase II, 24-week, randomised, placebo-controlled, double-blind study (JAHH), RNA was isolated from whole blood in 274 patients and an...
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BMJ Publishing Group
2020-10-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/7/1/e000424.full |
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| author | Daniel J Wallace Thomas Dörner Stephanie de Bono Robert J Benschop Ernst R Dow Damiano Fantini Richard E Higgs Guilherme Rocha Brenda Crowe Nicole L Byers Maria E Silk Robert W Hoffman |
| author_facet | Daniel J Wallace Thomas Dörner Stephanie de Bono Robert J Benschop Ernst R Dow Damiano Fantini Richard E Higgs Guilherme Rocha Brenda Crowe Nicole L Byers Maria E Silk Robert W Hoffman |
| author_sort | Daniel J Wallace |
| collection | DOAJ |
| description | Objective To characterise the molecular pathways impacted by the pharmacologic effects of the Janus kinase (JAK) 1 and JAK2 inhibitor baricitinib in SLE.Methods In a phase II, 24-week, randomised, placebo-controlled, double-blind study (JAHH), RNA was isolated from whole blood in 274 patients and analysed using Affymetrix HTA2.0 array. Serum cytokines were measured using ultrasensitive quantitative assays.Results Gene expression profiling demonstrated an elevation of STAT1, STAT2 and multiple interferon (IFN) responsive genes at baseline in patients with SLE. Statistical and gene network analyses demonstrated that baricitinib treatment reduced the mRNA expression of functionally interconnected genes involved in SLE including STAT1-target, STAT2-target and STAT4-target genes and multiple IFN responsive genes. At baseline, serum cytokines IFN-α, IFN-γ, interleukin (IL)-12p40 and IL-6 were measurable and elevated above healthy controls. Treatment with baricitinib significantly decreased serum IL-12p40 and IL-6 cytokine levels at week 12, which persisted through week 24.Conclusion Baricitinib treatment induced significant reduction in the RNA expression of a network of genes associated with the JAK/STAT pathway, cytokine signalling and SLE pathogenesis. Baricitinib consistently reduced serum levels of two key cytokines implicated in SLE pathogenesis, IL-12p40 and IL-6. |
| format | Article |
| id | doaj-art-e5cc766cafc64ce9bf61c760b2589fcd |
| institution | OA Journals |
| issn | 2053-8790 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj-art-e5cc766cafc64ce9bf61c760b2589fcd2025-08-20T01:56:24ZengBMJ Publishing GroupLupus Science and Medicine2053-87902020-10-017110.1136/lupus-2020-000424Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathwaysDaniel J Wallace0Thomas Dörner1Stephanie de Bono2Robert J Benschop3Ernst R Dow4Damiano Fantini5Richard E Higgs6Guilherme Rocha7Brenda Crowe8Nicole L Byers9Maria E Silk10Robert W Hoffman115Cedars-Sinai Medical Center/University California at Los Angeles, Los AngelesRheumatology and Clinical Immunology, Charite University Hospitals Berlin, Berlin, GermanyEli Lilly and Company, Indianapolis, Indiana, USALilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA6Eli Lilly and Company, Indianapolis, USA6Eli Lilly and Company, Indianapolis, USA5Eli Lilly and Company, Indianapolis, United States of America5Eli Lilly and Company, Indianapolis, United States of America6Eli Lilly and Company, Indianapolis, USA7 Eli Lilly and Company, Indianapolis, Indiana, USA6Eli Lilly and Company, Indianapolis, USA6Eli Lilly and Company, Indianapolis, USAObjective To characterise the molecular pathways impacted by the pharmacologic effects of the Janus kinase (JAK) 1 and JAK2 inhibitor baricitinib in SLE.Methods In a phase II, 24-week, randomised, placebo-controlled, double-blind study (JAHH), RNA was isolated from whole blood in 274 patients and analysed using Affymetrix HTA2.0 array. Serum cytokines were measured using ultrasensitive quantitative assays.Results Gene expression profiling demonstrated an elevation of STAT1, STAT2 and multiple interferon (IFN) responsive genes at baseline in patients with SLE. Statistical and gene network analyses demonstrated that baricitinib treatment reduced the mRNA expression of functionally interconnected genes involved in SLE including STAT1-target, STAT2-target and STAT4-target genes and multiple IFN responsive genes. At baseline, serum cytokines IFN-α, IFN-γ, interleukin (IL)-12p40 and IL-6 were measurable and elevated above healthy controls. Treatment with baricitinib significantly decreased serum IL-12p40 and IL-6 cytokine levels at week 12, which persisted through week 24.Conclusion Baricitinib treatment induced significant reduction in the RNA expression of a network of genes associated with the JAK/STAT pathway, cytokine signalling and SLE pathogenesis. Baricitinib consistently reduced serum levels of two key cytokines implicated in SLE pathogenesis, IL-12p40 and IL-6.https://lupus.bmj.com/content/7/1/e000424.full |
| spellingShingle | Daniel J Wallace Thomas Dörner Stephanie de Bono Robert J Benschop Ernst R Dow Damiano Fantini Richard E Higgs Guilherme Rocha Brenda Crowe Nicole L Byers Maria E Silk Robert W Hoffman Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways Lupus Science and Medicine |
| title | Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways |
| title_full | Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways |
| title_fullStr | Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways |
| title_full_unstemmed | Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways |
| title_short | Baricitinib-associated changes in global gene expression during a 24-week phase II clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune-related pathways |
| title_sort | baricitinib associated changes in global gene expression during a 24 week phase ii clinical systemic lupus erythematosus trial implicates a mechanism of action through multiple immune related pathways |
| url | https://lupus.bmj.com/content/7/1/e000424.full |
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