Institute of Immunology and the CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Life Science and Medical Center, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Hefei National Laboratory for Physical Sciences at Microscale, University of Science and Technology of China, Hefei, Anhui, 230001, China.
J Transl Med. 2020 Apr 14;18(1):164. doi: 10.1186/s12967-020-02339-3.
A severe pneumonia-associated respiratory syndrome caused by a new coronavirus was identified in December 2019 (COVID-19), spread rapidly and has become a world-wide public health challenge. About 25% of COVID-19 patients experienced severe complications including acute respiratory distress syndrome (ARDS), and even progressed into an intensive care unit (ICU) admission and died. The exploration for the mortality causes and advancing novel therapeutic development of severe COVID-19 is crucial at the moment. The biopsy samples analysis at autopsy suggested that increased alveolar exudate caused by aberrant host immune response and inflammatory cytokine storm probably impedes alveolar gas exchange and contributes to the high mortality of severe COVID-19 patients. Our research has identified that pathogenic T cells and inflammatory monocytes incite inflammatory storm with large amount of interleukin 6, therefore monoclonal antibody that targets the IL-6 pathways may potentially curb inflammatory storm. Moreover, Tocilizumab treatment that blocking IL-6 receptors showed inspiring clinical results including temperature returned to normal quickly and respiratory function improved. Therefore, we suggest that Tocilizumab is an effective treatment in severe patients of COVID-19 to calm the inflammatory storm and reduce mortality.
一种由新型冠状病毒引起的严重肺炎相关呼吸综合征于 2019 年 12 月被确认（COVID-19），该病毒迅速传播，已成为全球性的公共卫生挑战。约 25%的 COVID-19 患者出现严重并发症，包括急性呼吸窘迫综合征（ARDS），甚至进展为重症监护病房（ICU）入住和死亡。目前，探索 COVID-19 重症患者的死亡原因和推进新型治疗方法的开发至关重要。尸检样本分析表明，异常的宿主免疫反应和炎症细胞因子风暴导致肺泡渗出物增加，可能阻碍肺泡气体交换，导致 COVID-19 重症患者的高死亡率。我们的研究已经确定，致病性 T 细胞和炎症性单核细胞引发炎症风暴，释放大量白细胞介素 6，因此针对 IL-6 途径的单克隆抗体可能潜在地抑制炎症风暴。此外，阻断 IL-6 受体的托珠单抗治疗显示出令人鼓舞的临床结果，包括体温迅速恢复正常和呼吸功能改善。因此，我们建议托珠单抗是 COVID-19 重症患者的有效治疗方法，可平息炎症风暴并降低死亡率。
