Department of Internal Medicine, Ota and Jinemed Hospital, Istanbul, Turkey.
Department of Rheumatology, Meram Tip Faculty, Necmettin Erbakan University, Konya, Turkey.
Indian J Pharmacol. 2021 May-Jun;53(3):226-228. doi: 10.4103/ijp.IJP_615_20.
Although many potent drugs have been used for cytokine storm, mortality is high for patients with coronavirus disease-2019 (COVID-19), which is followed up in the intensive care unit. Interferons (IFNs) are the major cytokines of the antiviral defense system released from many cell types. However, IFN-γ plays a key role in both primary and secondary cytokine storms. If the cytokine storm is not treated urgently, it will be fatal; therefore, it should be treated immediately. Anakinra, an interleukin-1 (IL-1) antagonist, tocilizumab, an IL-6 antagonist, and Janus kinase (JAK) inhibitors are successfully used in cytokine storm caused by COVID-19. However, sometimes, despite these treatments, the patient's clinical course does not improve. Emapalumab (Eb) is the human immunoglobulin G1 monoclonal antibody and is a potent and noncompetitive antagonist of IFN-γ. Eb can be life saving for cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and JAK inhibitors.
虽然有许多强效药物可用于治疗细胞因子风暴,但在重症监护病房中接受治疗的 2019 年冠状病毒病(COVID-19)患者死亡率仍然很高。干扰素(IFN)是许多细胞类型释放的抗病毒防御系统的主要细胞因子。然而,IFN-γ 在原发性和继发性细胞因子风暴中都发挥着关键作用。如果不紧急治疗细胞因子风暴,将是致命的;因此,应立即进行治疗。白细胞介素-1(IL-1)拮抗剂阿那白滞素、IL-6 拮抗剂托珠单抗和 Janus 激酶(JAK)抑制剂已成功用于 COVID-19 引起的细胞因子风暴。然而,有时尽管进行了这些治疗,患者的临床病程仍未改善。Emapalumab(Eb)是人免疫球蛋白 G1 单克隆抗体,是 IFN-γ 的有效且非竞争性拮抗剂。对于对抗生素、托珠单抗和 JAK 抑制剂耐药的 COVID-19 引起的细胞因子风暴,Eb 可以挽救生命。
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