Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates.
Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates.
Life Sci. 2020 Sep 15;257:118054. doi: 10.1016/j.lfs.2020.118054. Epub 2020 Jul 11.
The outbreak of Coronavirus disease 2019 (COVID-19) is the current world health concern, presenting a public health dilemma with ascending morbidity and mortality rates exceeding any previous viral spread, without a standard effective treatment yet. SARS-CoV-2 infection is distinguished with multiple epidemiological and pathological features, one of them being the elevated levels of cytokine release, which in turn trigger an aberrant uncontrolled response known as "cytokine storm". This phenomenon contributes to severe acute respiratory distress syndrome (ARDS), leading to pneumonia and respiratory failure, which is considered a major contributor to COVID-19-associated fatality rates. Taking into account that the vast majority of the COVID-19 cases are aggravated by the respiratory and multiorgan failure triggered by the sustained release of cytokines, implementing therapeutics that alleviate or diminish the upregulated inflammatory response would provide a therapeutic advantage to COVID-19 patients. Indeed, dexamethasone, a widely available and inexpensive corticosteroid with anti-inflammatory effects, has shown a great promise in reducing mortality rates in COVID-19 patients. In this review, we have critically compared the clinical impact of several potential therapeutic agents that could block or interfere with the cytokine storm, such as IL-1 inhibitors, IL-6 inhibitors, mast cell targeting agents, and corticosteroids. This work focused on highlighting and contrasting the current success and limitations towards the involvement of these agents in future treatment protocols.
2019 年冠状病毒病（COVID-19）的爆发是当前全球关注的健康问题，它带来了公共卫生的困境，发病率和死亡率呈上升趋势，超过了以往任何一次病毒传播，而目前还没有标准的有效治疗方法。SARS-CoV-2 感染具有多种流行病学和病理学特征，其中之一是细胞因子释放水平升高，这反过来又引发了一种称为“细胞因子风暴”的异常失控反应。这种现象导致严重急性呼吸窘迫综合征（ARDS），导致肺炎和呼吸衰竭，这被认为是 COVID-19 相关死亡率的主要原因。鉴于绝大多数 COVID-19 病例因细胞因子持续释放引发的呼吸和多器官衰竭而加重，实施减轻或抑制上调炎症反应的治疗方法将为 COVID-19 患者提供治疗优势。事实上，地塞米松是一种广泛应用且廉价的具有抗炎作用的皮质类固醇，已显示出在降低 COVID-19 患者死亡率方面的巨大潜力。在这篇综述中，我们批判性地比较了几种潜在的治疗药物的临床影响，这些药物可以阻断或干扰细胞因子风暴，如 IL-1 抑制剂、IL-6 抑制剂、肥大细胞靶向药物和皮质类固醇。这项工作重点强调并对比了这些药物在未来治疗方案中的参与的当前成功和局限性。
