Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Rheumatology Unit, Internal Medicine Department, ASST Sette Laghi, Ospedale Di Circolo - Fondazione Macchi, Varese, Italy.
Expert Rev Clin Immunol. 2021 Jun;17(6):601-618. doi: 10.1080/1744666X.2021.1919086. Epub 2021 May 27.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces a dysregulated hyperinflammatory response.
Authors review evidence on IL-6 and IL-6 blockade in coronavirus disease 2019 (COVID-19) and discuss the pathophysiological and prognostic roles of this cytokine and the clinical impact of pharmacological blockade of IL-6 . The material includes original articles and reviews published from March 2020 to March 2021 and searched on PubMed, medRxiv, and bioRxiv.
IL-6 is one of the most prominent pro-inflammatory cytokines. Increased levels are recorded in COVID-19 patients, especially those with severe-to-critical disease. Evidence is accumulating on the relevance of IL-6 as a prognostic marker in COVID-19. Since IL-6 is a druggable target for several inflammatory diseases, pharmacological blockers of the IL-6 signaling pathway were repurposed to blunt the abnormal SARS-CoV-2-induced cytokine release. Data are limited to few randomized controlled trials that reported encouraging, though not conclusive, results, indicating the usefulness of IL-6 blockade early in the course of the disease in patients with hyperinflammation and no or limited organ damage. Further research is warranted to explore the role of IL-6 in different COVID-19 phenotypes and identify subgroups of patients who may mostly benefit from IL-6 pathway inhibition.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起失调的过度炎症反应。
作者回顾了白细胞介素 6（IL-6）及其在 2019 年冠状病毒病（COVID-19）中阻断作用的证据，并讨论了这种细胞因子的病理生理和预后作用，以及 IL-6 药理学阻断的临床影响。该材料包括 2020 年 3 月至 2021 年 3 月期间在 PubMed、medRxiv 和 bioRxiv 上发表的原始文章和综述。
白细胞介素 6（IL-6）是最突出的促炎细胞因子之一。COVID-19 患者，尤其是重症至危重症患者，其水平升高。越来越多的证据表明，IL-6 作为 COVID-19 的预后标志物具有相关性。由于 IL-6 是几种炎症性疾病的可治疗靶点，因此 IL-6 信号通路的药理学抑制剂被重新用于抑制 SARS-CoV-2 诱导的异常细胞因子释放。目前的数据仅限于少数随机对照试验，这些试验报告了令人鼓舞但非结论性的结果，表明在疾病早期对过度炎症且无或仅有有限器官损伤的患者进行 IL-6 阻断具有一定作用。需要进一步研究以探索 IL-6 在不同 COVID-19 表型中的作用，并确定最有可能从 IL-6 途径抑制中获益的患者亚组。
