Cavalli Giulio, Farina Nicola, Campochiaro Corrado, De Luca Giacomo, Della-Torre Emanuel, Tomelleri Alessandro, Dagna Lorenzo
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Front Pharmacol. 2020 Dec 18;11:598308. doi: 10.3389/fphar.2020.598308. eCollection 2020.
Coronavirus disease 2019 (COVID-19) is a condition caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe cases of COVID-19 result in acute respiratory distress syndrome and death. A detrimental, hyper-inflammatory immune response with excess release of cytokines is the main driver of disease development and of tissue damage in these patients. Thus, repurposing of biologic agents and other pharmacological inhibitors of cytokines used for the treatment of various inflammatory conditions emerged as a logical therapeutic strategy to quench inflammation and improve the clinical outcome of COVID-19 patients. Evaluated agents include the interleukin one receptor blocker anakinra, monoclonal antibodies inhibiting IL-6 tocilizumab and sarilumab, monoclonal antibodies inhibiting granulocyte-monocyte colony stimulating factor and tumor necrosis factor, and Janus kinase inhibitors. In this review, we discuss the efficacy and safety of these therapeutic options based on direct personal experience and on published evidence from observational studies and randomized clinical trials.
2019冠状病毒病（COVID-19）是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的一种疾病。COVID-19重症病例会导致急性呼吸窘迫综合征和死亡。细胞因子过度释放所引发的有害、过度炎症性免疫反应是这些患者疾病发展和组织损伤的主要驱动因素。因此，重新利用用于治疗各种炎症性疾病的生物制剂和其他细胞因子药理学抑制剂，成为一种合理的治疗策略，以减轻炎症并改善COVID-19患者的临床结局。评估的药物包括白细胞介素-1受体阻滞剂阿那白滞素、抑制IL-6的单克隆抗体托珠单抗和萨瑞鲁单抗、抑制粒细胞-单核细胞集落刺激因子和肿瘤坏死因子的单克隆抗体，以及Janus激酶抑制剂。在本综述中，我们基于直接的个人经验以及观察性研究和随机临床试验的已发表证据，讨论这些治疗选择的疗效和安全性。
