JAK inhibition increases bone mass in steady-state conditions and ameliorates pathological bone loss by stimulating osteoblast function

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Susanne Adam - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Nils Simon - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Ulrike Steffen - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Fabian T Andes - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Carina Scholtysek - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Dorothea I H Müller - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Daniela Weidner - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Darja Andreev - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Arnd Kleyer - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Stephan Culemann - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Madelaine Hahn - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Georg Schett - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Gerhard Krönke - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Silke Frey - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Axel J Hueber - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)

Abstract

Janus kinase (JAK)-mediated cytokine signaling has emerged as an important therapeutic target for the treatment of inflammatory diseases such as rheumatoid arthritis (RA). Accordingly, JAK inhibitors compose a new class of drugs, among which tofacitinib and baricitinib have been approved for the treatment of RA. Periarticular bone erosions contribute considerably to the pathogenesis of RA. However, although the immunomodulatory aspect of JAK inhibition (JAKi) is well defined, the current knowledge of how JAKi influences bone homeostasis is limited. Here, we assessed the effects of the JAK inhibitors tofacitinib and baricitinib on bone phenotype (i) in mice during steady-state conditions or in mice with bone loss induced by (ii) estrogen-deficiency (ovariectomy) or (iii) inflammation (arthritis) to evaluate whether effects of JAKi on bone metabolism require noninflammatory/inflammatory challenge. In all three models, JAKi increased bone mass, consistent with reducing the ratio of receptor activator of NF-κB ligand/osteoprotegerin in serum. In vitro, effects of tofacitinib and baricitinib on osteoclast and osteoblast differentiation were analyzed. JAKi significantly increased osteoblast function (P < 0.05) but showed no direct effects on osteoclasts. Additionally, mRNA sequencing and ingenuity pathway analyses were performed in osteoblasts exposed to JAKi and revealed robust up-regulation of markers for osteoblast function, such as osteocalcin and Wnt signaling. The anabolic effect of JAKi was illustrated by the stabilization of β-catenin. In humans with RA, JAKi induced bone-anabolic effects as evidenced by repair of arthritic bone erosions. Results support that JAKi is a potent therapeutic tool for increasing osteoblast function and bone formation.

Details

Original languageEnglish
JournalScience translational medicine
Volume12
Issue number530
Publication statusPublished - 12 Feb 2020
Peer-reviewedYes
Externally publishedYes

External IDs

Scopus 85079338077

Keywords

Research priority areas of TU Dresden

Keywords

  • Arthritis, Rheumatoid, Cell Differentiation, Janus Kinase Inhibitors, Janus Kinases, Osteoblasts, Osteoclasts