Institute of Biomedical Health Technology and Engineering, Shenzhen Bay Laboratory, Shenzhen, 518132, China.
School of Physics and Technology, Wuhan University, Wuhan, 430072, China.
Adv Mater. 2021 May;33(20):e2100012. doi: 10.1002/adma.202100012. Epub 2021 Apr 10.
The COVID-19 pandemic, induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused great impact on the global economy and people's daily life. In the clinic, most patients with COVID-19 show none or mild symptoms, while approximately 20% of them develop severe pneumonia, multiple organ failure, or septic shock due to infection-induced cytokine release syndrome (the so-called "cytokine storm"). Neutralizing antibodies targeting inflammatory cytokines may potentially curb immunopathology caused by COVID-19; however, the complexity of cytokine interactions and the multiplicity of cytokine targets make attenuating the cytokine storm challenging. Nonspecific in vivo biodistribution and dose-limiting side effects further limit the broad application of those free antibodies. Recent advances in biomaterials and nanotechnology have offered many promising opportunities for infectious and inflammatory diseases. Here, potential mechanisms of COVID-19 cytokine storm are first discussed, and relevant therapeutic strategies and ongoing clinical trials are then reviewed. Furthermore, recent research involving emerging biomaterials for improving antibody-based and broad-spectrum cytokine neutralization is summarized. It is anticipated that this work will provide insights on the development of novel therapeutics toward efficacious management of COVID-19 cytokine storm and other inflammatory diseases.
由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的 COVID-19 大流行对全球经济和人们的日常生活造成了重大影响。在临床上,大多数 COVID-19 患者表现为无症状或轻症,但约 20%的患者由于感染引起的细胞因子释放综合征(所谓的“细胞因子风暴”)而发展为重症肺炎、多器官衰竭或感染性休克。针对炎症细胞因子的中和抗体可能潜在地抑制 COVID-19 引起的免疫病理学;然而,细胞因子相互作用的复杂性和细胞因子靶点的多样性使得减弱细胞因子风暴具有挑战性。体内非特异性生物分布和剂量限制的副作用进一步限制了这些游离抗体的广泛应用。生物材料和纳米技术的最新进展为传染病和炎症性疾病提供了许多有前途的机会。在这里,首先讨论了 COVID-19 细胞因子风暴的潜在机制,然后回顾了相关的治疗策略和正在进行的临床试验。此外,还总结了最近涉及新兴生物材料以改善基于抗体和广谱细胞因子中和的研究。预计这项工作将为开发针对 COVID-19 细胞因子风暴和其他炎症性疾病的有效治疗方法提供新的思路。