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REVIEW article

Front. Med.

Sec. Infectious Diseases: Pathogenesis and Therapy

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1643068

A Case Displaying the Importance of JAK1 And JAK2 Gene Transcription in Antifungal Defense Against Coccidioidomycosis

Provisionally accepted
Jennifer  K PriessnitzJennifer K Priessnitz1,2*Taylor  ColoreTaylor Colore3Nelson  NicolasoraNelson Nicolasora2*
  • 1Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, United States
  • 2The University of Arizona College of Medicine Phoenix, Phoenix, United States
  • 3Grenada, Saint George's, Grenada

The final, formatted version of the article will be published soon.

This case report explores the consequences of ruxolitinib via inhibition janus kinase 1 (JAK1) and JAK2 pathways in the context of fungal defense in a patient diagnosed with pulmonary coccidioidomycosis during ruxolitinib therapy for polycythemia vera. The patient experienced a relapse of pulmonary coccidioidomycosis after antifungal treatment was discontinued while continuing ruxolitinib use. This case illustrates the heightened risk of discontinuing antifungal therapy in endemic regions, emphasizing the critical need for continued monitoring. Furthermore, this case underscores the vital role of the JAK1 and JAK2 signaling cascade, particularly the interferon-gamma (INF-γ)-JAK1 and JAK2-signal transducer and activator of transcription 1 (STAT) axis, in antifungal defense. Recent studies have revealed that the loss of function in JAK1 (but not JAK2), leads to impaired macrophage activation and reduced T-helper 1 (Th1) cell responses, thereby compromising the body's ability to fight off dimorphic fungi, such as Coccidioides. Other proposed fungal immune mechanisms in the JAK-STAT pathway are discussed. Clinicians tailoring JAK inhibitor treatment options for patients must be aware of the INF-γ-JAK1-STAT pathway's pivotal role in antifungal defense.

Keywords: JAK1 and JAK2 inhibitors, Ruxolitinb, Coccidioidomycosis, Coccidioidomycosis/immunology, JAK STAT signaling pathway, antifungal immunity

Received: 12 Jun 2025; Accepted: 05 Sep 2025.

Copyright: © 2025 Priessnitz, Colore and Nicolasora. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Jennifer K Priessnitz, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, United States
Nelson Nicolasora, The University of Arizona College of Medicine Phoenix, Phoenix, United States

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