A global team of researchers has identified JAK inhibitors as a potential life-saving treatment for toxic epidermal necrolysis (TEN), a rare but often fatal reaction to common medications. The breakthrough, published in Nature, stems from the use of spatial proteomics to analyze skin samples from TEN patients, revealing the inflammatory JAK/STAT pathway as a key driver of the disease.
Deep Visual Proteomics Uncovers Therapeutic Target
The researchers employed Deep Visual Proteomics (DVP), a cutting-edge approach that combines microscopy, AI-driven analysis, laser-guided microdissection, and mass spectrometry. This allowed them to create a detailed map of the proteins driving the deadly reaction at the cellular level.
"By applying spatial proteomics to archived patient samples suffering from TEN, we were able to precisely isolate and analyze individual cell types and understand what is actually occurring in the skin of these patients," explained Thierry Nordmann, first author and clinician-scientist at the Max Planck Institute of Biochemistry and Ludwig Maximilians Universität München. "We identified a striking hyperactivation of the inflammatory JAK/STAT pathway, revealing an opportunity to intervene in this deadly condition with JAK inhibitors."
Validation and Clinical Response
The team validated their findings through in vitro and in vivo studies, including two distinct mouse models. The results consistently pointed to the potential of JAK inhibitors. Subsequently, in collaboration with clinical teams at the First Affiliated Hospital of Fujian Medical University in China, seven patients with TEN were treated with JAK inhibitors. All seven experienced rapid improvement and full recovery.
Implications and Future Directions
"The new evidence that inhibition of the JAK/STAT pathway has potential to reduce the high mortality of this severe adverse cutaneous drug reaction paves the way for clinical trials aimed at regulatory approval of JAK inhibitors to solve one of the most serious unmet needs in medicine," said Lars French, co-corresponding author and Chair of Dermatology at LMU Munich.
While larger clinical trials are necessary to confirm the efficacy and safety of JAK inhibitors in TEN, this study offers hope for patients facing this devastating condition. The Max Planck Society and Ludwig Maximilian University have filed patent applications for the use of JAK inhibitors in treating TEN and related conditions.
"Our findings not only open new avenues for treating TEN but also highlight the potential of spatial proteomics in driving medical breakthroughs," said Matthias Mann. "To our knowledge, this is the first time a spatial omics technology has made an immediate and tangible impact in the clinic, by identifying a treatment that has already changed people's lives for the good. This approach could be applied to a wide range of diseases, potentially accelerating drug discovery across multiple fields of medicine."
