Preventive Therapies for Chronic Migraine

Balfagón, Gloria; Blanco-Rivero, Javier; Márquez-Rodas, Iván

doi:10.1056/nejmc1716990

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Tofacitinib is used to treat rheumatoid arthritis and is effective in methotrexate-naïve and DMARD-experienced patients, including those who are unresponsive to TNF inhibitors (26,45,46). Recently, some studies revealed that tofacitinib also has a protective effect against other diseases caused by immune disorders, such as inflammatory bowel disease (47) and alopecia universalis (48,49). It was observed that cytokines and the JAK/STAT pathways they participate in also play important roles in patients with AIH (50) and mice with ConA-induced hepatitis (51); this has led to the investigation of whether tofacitinib can also play a protective role against immune-mediated hepatitis.…”

Section: Discussionmentioning

confidence: 99%

The JAK inhibitor tofacitinib ameliorates immune‑mediated liver injury in mice

et al. 2019

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The prevalence of immune-mediated liver diseases such as autoimmune liver disease or viral hepatitis has increased in recent years, and the side effects of pre-existing treatments are a worldwide problem. Regulatory T cells (Tregs) and T helper 17 (Th17) cells play important roles in the development of immune-mediated hepatitis and may serve as potential therapeutic targets. Tofacitinib, a new Janus kinase (JAK) inhibitor, is under investigation for the treatment of rheumatoid arthritis; it is also helpful in treating ulcerative colitis and psoriasis. The roles of tofacitinib were investigated in conferring protection against immune-mediated liver injury in mice. T cell-mediated hepatitis was induced by concanavalin A (ConA). The mice in the treatment groups were administered with tofacitinib intragastrically before the ConA injection. Histopathological examination was performed by hematoxylin and eosin (H&E) staining, and the serum transaminase and inflammatory cytokine levels were determined using an automatic biochemistry analysis apparatus or cytometric bead array (CBA) kits. Flow cytometric analysis was used to detect Tregs and Th17 cells. Tofacitinib significantly decreased the hepatic injury induced by ConA and prominently decreased the liver transaminase level. The secretion of several anti-inflammatory cytokines such as interleukin (IL)-10 was upregulated in mice from the treatment group, compared to that in mice treated with ConA alone, while the expression of interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) decreased. Tofacitinib treatment increased the number of Tregs and reduced the number of Th17 cells. Furthermore, tofacitinib could relieve liver fibrosis under conditions of autoimmune hepatitis (AIH). The present results indicated that tofacitinib improved immune-mediated hepatitis and restored the impaired Treg/Th17 cell ratio, which suggests that it may serve as a novel treatment approach for immune-mediated liver diseases.

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Section: Discussionmentioning

confidence: 99%

The JAK inhibitor tofacitinib ameliorates immune‑mediated liver injury in mice

et al. 2019

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A Case Report of Successful Treatment of Severe Immunotherapy-related Hepatitis in a Patient with advanced Lung Squamous-cell carcinoma

Zhou

Hou

Liu

et al. 2023

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In the last decade, the use of immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) and its ligand (PD-L1) has significantly improved prognosis of patients with advanced malignant tumors (1). But immunotherapy-related adverse events (irAEs) were observed more often in the process of treatment(2). Immunotherapy-related adverse events may impair many organs, including endocrine system, skin, heart, lung, and liver. Though infrequent, irAEs may induce severe outcomes and influence subsequent therapy of cancer. Immunotherapy-related hepatitis (IRH) is one of the major irAEs. Reported incidence of IRH varies from 0.7–16%(3). Immunosuppressants are often considered when glucocorticoid does not respond well in treatment of IRH. There were reports of effective use of mycophenolate mofetil(4) and tacrolimus(5)in treatment of IRH. Infliximab is contraindicated for the treatment of IRH due to the risk of inducing further liver damage(6–8). However, benefits of these agents are uncertain when satisfactory effect of sufficient steroid was not seen. Reason may lie in complex situation of steroid resistant IRH. In this article, we reported a patient with lung squamous cell carcinoma who developed severe IRH after one cycle of PD-1 inhibitor. After comprehensive treatment of glucocorticoid, tofacitinib, artificial liver support system and other supportive treatments, the patient's liver function returned to normal.

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Preventive Therapies for Chronic Migraine

Cited by 2 publications

References 14 publications

The JAK inhibitor tofacitinib ameliorates immune‑mediated liver injury in mice

The JAK inhibitor tofacitinib ameliorates immune‑mediated liver injury in mice

A Case Report of Successful Treatment of Severe Immunotherapy-related Hepatitis in a Patient with advanced Lung Squamous-cell carcinoma

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