The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the Editor
Editor, - I was interested to read the recent article on Janus kinase inhibitors by Paul Kubler (Aust Prescr 2014;37:154-7). In addition to being pro-cancer, the Janus kinase-Signal Transducer and Activation of Transcription (JAK-STAT) pathway is part of a central physiological pro-survival mechanism.1 Thus pharmacological targeting of this signalling cascade may pose potential threats, for example to cardiac integrity.2 Targeting JAK-STAT will also potentially challenge neuroprotection.3 Conversely, activation of JAK-STAT is proposed as a tangible approach to managing heart disease.4
The message is that there is a clinically highly relevant ‘crossroads’ between physiology and cancer, thus maintaining the truly holistic viewpoint. Therefore treatments aimed at targeting cancer necessarily target normal tissues and in turn define burgeoning fields within cancer-related therapy such as cardio-oncology. Activating a pro-survival pathway such as JAK-STAT therapeutically to manage heart disease removes a barrier in the multiple-step process of oncogenesis. Targeting the JAK-STAT pathway is in a sense ‘non-specifically specific’. The target may be a defined one, but the target itself is universally expressed.
Future developments in therapeutics must be designed to be ‘specifically specific’ to the disease target to be effective, yet with little fear of resultant adverse reaction.
John A Loudon
Baulkham Hills NSW
- Loudon JA. A novel prosurvival model for cancer under environmental challenge: the ‘heart-felt’ message for therapeutic intervention. Oncol Res 2011;19:407-43.
- Fischer P, Hilfiker-Kleiner D. Role of gp130-mediated signalling pathways in the heart and its impacton potential therapeutic aspects. Br J Pharmacol 2008;153:S414-27.
- Oliva AA Jr, Kang Y, Sanchez-Molano J, Furones C, Atkins CM. STAT3 signaling after traumatic brain injury.J Neurochem 2012;120:710-20.
- Fujio Y, Maeda M, Mohri T, Obana M, Iwakura T, Hayama A, et al. Glycoprotein 130 cytokine signal as a therapeutic target against cardiovascular diseases. J Pharmacol Sci 2011;117:213-22.