IV-th Department of Medicine, Safarik University, Kosice, Slovakia.
Immunol Lett. 2020 Dec;228:38-44. doi: 10.1016/j.imlet.2020.09.007. Epub 2020 Sep 29.
Cytokine storm is a form of uncontrolled systemic inflammatory reaction activated by a variety of factors and leading to a harmful homeostatic process, even to patient's death. Triggers that start the reaction are infection, systemic diseases and rarely anaphylaxis. Cytokine storm is frequently mentioned in connection to medical interventions such as transplantation or administration of drugs. Presented mini-review would like to show current possibilities how to fight or even stop such a life-threatening, immune-mediated process in order to save lives, not only in COVID-19 patients. Early identification of rising state and multilevel course of treatment is imperative. The most widely used molecule for systemic treatment remains tocilizumab. Except for anti IL-6 treatment, contemporary research opens the possibilities for combination of pharmaceutical, non-pharmaceutical and adjunctive treatment in a successful fight with consequences of cytokine storm. Further work is needed to discover the exact signaling pathways that lead to cytokine storm and to determine how these effector molecules and/or combination of processes can help to resolve this frequently fatal episode of inflammation. It is a huge need for all scientists and clinicians to establish a physiological rational for new therapeutic targets that might lead to more personalized medicine approaches.
细胞因子风暴是一种由多种因素激活的失控性全身炎症反应,导致有害的体内平衡过程,甚至导致患者死亡。引发反应的触发因素有感染、系统性疾病,极少数情况下还有过敏反应。细胞因子风暴经常与移植或药物治疗等医学干预措施相关联。本文综述旨在展示目前有哪些可能的方法可以对抗甚至阻止这种危及生命的免疫介导过程,以拯救生命,而不仅仅是在 COVID-19 患者中。早期识别上升状态和多水平治疗过程至关重要。目前最广泛用于全身治疗的分子仍然是托珠单抗。除了抗 IL-6 治疗外,当代研究还为药物、非药物和辅助治疗的联合治疗开辟了可能性,以成功应对细胞因子风暴的后果。还需要进一步的研究来发现导致细胞因子风暴的确切信号通路,并确定这些效应分子和/或过程的组合如何有助于解决这种经常致命的炎症发作。所有科学家和临床医生都需要建立新的治疗靶点的生理合理性,这可能会导致更个性化的医疗方法。