Liu Jingping, Wan Meihua, Lyon Christopher J, Hu Tony Y
Key Laboratory of Transplant Engineering and Immunology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China.
Theranostics. 2020 Jul 25;10(21):9591-9600. doi: 10.7150/thno.47982. eCollection 2020.
Cytokine storms, defined by the dysregulated and excessive production of multiple pro-inflammatory cytokines, are closely associated with the pathology and mortality of several infectious diseases, including coronavirus disease 2019 (COVID-19). Effective therapies are urgently needed to block the development of cytokine storms to improve patient outcomes, but approaches that target individual cytokines may have limited effect due to the number of cytokines involved in this process. Dysfunctional macrophages appear to play an essential role in cytokine storm development, and therapeutic interventions that target these cells may be a more feasible approach than targeting specific cytokines. Nanomedicine-based therapeutics that target macrophages have recently been shown to reduce cytokine production in animal models of diseases that are associated with excessive proinflammatory responses. In this mini-review, we summarize important studies and discuss how macrophage-targeted nanomedicines can be employed to attenuate cytokine storms and their associated pathological effects to improve outcomes in patients with severe infections or other conditions associated with excessive pro-inflammatory responses. We also discuss engineering approaches that can improve nanocarriers targeting efficiency to macrophages, and key issues should be considered before initiating such studies.
细胞因子风暴是由多种促炎细胞因子的失调和过度产生所定义的，与包括2019冠状病毒病（COVID-19）在内的几种传染病的病理和死亡率密切相关。迫切需要有效的疗法来阻止细胞因子风暴的发展，以改善患者的预后，但由于参与这一过程的细胞因子数量众多，针对单个细胞因子的方法可能效果有限。功能失调的巨噬细胞似乎在细胞因子风暴的发展中起关键作用，针对这些细胞的治疗干预可能比针对特定细胞因子的方法更可行。最近的研究表明，在与过度促炎反应相关的疾病动物模型中，基于纳米医学的针对巨噬细胞的疗法可减少细胞因子的产生。在本综述中，我们总结了重要研究，并讨论了如何利用靶向巨噬细胞的纳米药物来减轻细胞因子风暴及其相关的病理效应，以改善重症感染患者或与过度促炎反应相关的其他病症患者的预后。我们还讨论了可提高纳米载体对巨噬细胞靶向效率的工程方法，以及在开展此类研究之前应考虑的关键问题。
