文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

细胞因子飘移——摒弃“细胞因子风暴”的理由。

Cytokine Drizzle-The Rationale for Abandoning "Cytokine Storm".

机构信息

Department of Surgery, Boston Medical Center, Boston University, Boston, Massachusetts.

Department of Pathology and Laboratory Medicine, Boston University, Boston, Massachusetts.

出版信息

Shock. 2021 Nov 1;56(5):667-672. doi: 10.1097/SHK.0000000000001769.


DOI:10.1097/SHK.0000000000001769
PMID:34652339
Abstract

BACKGROUND: "Cytokine storm" has been used to implicate increased cytokine levels in the pathogenesis of serious clinical conditions. Similarities with Severe Acute Respiratory Syndrome Coronoavirus-2 (SARS CoV-2) and the 2012 Middle Eastern Respiratory Syndrome led early investigators to suspect a "cytokine storm" resulting in an unregulated inflammatory response associated with the significant morbidity and mortality induced by SARS CoV-2. The threshold of blood cytokines necessary to qualify as a "cytokine storm" has yet to be defined. METHODS: A literature review was conducted to identify cytokine levels released during 11 assorted clinical conditions or diseases. Weighted averages for various cytokines were calculated by multiplying the number of patients in the paper by the average concentration of each cytokine. Correlation between cytokine levels for individual conditions or diseases were assessed using Pearson correlation coefficient. RESULTS: The literature was reviewed to determine blood levels of cytokines in a wide variety of clinical conditions. These conditions ranged from exercise and autoimmune disease to septic shock and therapy with chimeric antigen receptor T cells. The most frequently measured cytokine was IL-6 which ranged from 24,123 pg/mL in septic shock to 11 pg/mL after exercise. In patients with severe SARS CoV-2 infections, blood levels of IL-6 were only 43 pg/mL, nearly three magnitudes lower than IL-6 levels in patients with septic shock. The clinical presentations of these different diseases do not correlate with blood levels of cytokines. Additionally, there is poor correlation between the concentrations of different cytokines among the different diseases. Specifically, blood levels of IL-6 did not correlate with levels of IL-8, IL-10, or TNF. Septic shock had the highest concentrations of cytokines, yet multiple cytokine inhibitors have failed to demonstrate improved outcomes in multiple clinical trials. Patients with autoimmune diseases have very low blood levels of cytokines (rheumatoid arthritis, IL-6 = 34 pg/mL; Crohn's disease, IL-6 = 5 pg/mL), yet respond dramatically to cytokine inhibitors. CONCLUSION: The misleading term "cytokine storm" implies increased blood levels of cytokines are responsible for a grave clinical condition. Not all inflammatory conditions resulting in worsened disease states are correlated with significantly elevated cytokine levels, despite an association with the term "cytokine storm". "Cytokine storm" should be removed from the medical lexicon since it does not reflect the mediators driving the disease nor does it predict which diseases will respond to cytokine inhibitors.

摘要

背景:“细胞因子风暴”被用来暗示严重临床病症中细胞因子水平的增加。与严重急性呼吸系统综合征冠状病毒 2 型(SARS-CoV-2)和 2012 年中东呼吸系统综合征的相似之处促使早期研究人员怀疑存在“细胞因子风暴”,导致不受调节的炎症反应与 SARS-CoV-2 引起的显著发病率和死亡率相关。将血液细胞因子作为“细胞因子风暴”的阈值尚未确定。

方法:进行文献回顾,以确定 11 种不同临床病症或疾病期间释放的细胞因子水平。通过将论文中的患者人数乘以每种细胞因子的平均浓度,计算出各种细胞因子的加权平均值。使用皮尔逊相关系数评估个体病症或疾病之间细胞因子水平的相关性。

结果:对文献进行了回顾,以确定广泛的临床病症中细胞因子的血液水平。这些病症的范围从运动和自身免疫性疾病到感染性休克和嵌合抗原受体 T 细胞治疗。最常测量的细胞因子是白细胞介素 6(IL-6),其在感染性休克中的范围为 24123pg/mL,在运动后为 11pg/mL。在严重 SARS-CoV-2 感染的患者中,IL-6 的血液水平仅为 43pg/mL,比感染性休克患者的 IL-6 水平低三个数量级。这些不同疾病的临床表现与细胞因子的血液水平不相关。此外,不同疾病之间细胞因子的浓度之间相关性较差。具体来说,IL-6 的血液水平与 IL-8、IL-10 或 TNF 不相关。感染性休克具有最高浓度的细胞因子,但多种细胞因子抑制剂未能在多项临床试验中显示出改善的结果。患有自身免疫性疾病的患者血液细胞因子水平非常低(类风湿关节炎,IL-6=34pg/mL;克罗恩病,IL-6=5pg/mL),但对细胞因子抑制剂反应剧烈。

结论:误导性术语“细胞因子风暴”暗示增加的血液细胞因子水平是导致严重临床病症的原因。并非所有导致疾病恶化的炎症病症都与显著升高的细胞因子水平相关,尽管与“细胞因子风暴”有关。“细胞因子风暴”应该从医学词汇中删除,因为它既不能反映驱动疾病的介质,也不能预测哪些疾病将对细胞因子抑制剂有反应。

相似文献

[1]
Cytokine Drizzle-The Rationale for Abandoning "Cytokine Storm".

Shock. 2021-11-1

[2]
Cytokine storm of a different flavour: The different cytokine signature of SARS-CoV-2, the cause of COVID-19, from the original SARS outbreak.

J Glob Antimicrob Resist. 2021-3

[3]
Coronavirus-19 (SARS-CoV-2) induces acute severe lung inflammation via IL-1 causing cytokine storm in COVID-19: a promising inhibitory strategy.

J Biol Regul Homeost Agents. 2020

[4]
Helminth alleviates COVID-19-related cytokine storm in an IL-9-dependent way.

mBio. 2024-6-12

[5]
Specific cytokines in the inflammatory cytokine storm of patients with COVID-19-associated acute respiratory distress syndrome and extrapulmonary multiple-organ dysfunction.

Virol J. 2021-6-4

[6]
IL-6: from arthritis to CAR-T-cell therapy and COVID-19.

Int Immunol. 2021-9-25

[7]
Cytokine storm and leukocyte changes in mild versus severe SARS-CoV-2 infection: Review of 3939 COVID-19 patients in China and emerging pathogenesis and therapy concepts.

J Leukoc Biol. 2020-6-13

[8]
Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors.

Emerg Microbes Infect. 2020-12

[9]
Mast cells activated by SARS-CoV-2 release histamine which increases IL-1 levels causing cytokine storm and inflammatory reaction in COVID-19.

J Biol Regul Homeost Agents.

[10]
Deciphering the COVID-19 cytokine storm: Systematic review and meta-analysis.

Eur J Clin Invest. 2021-1

引用本文的文献

[1]
Compartmentalization of the inflammatory response during bacterial sepsis and severe COVID-19.

J Intensive Med. 2024-2-27

[2]
The critical impacts of cytokine storms in respiratory disorders.

Heliyon. 2024-4-17

[3]
Immunoactivation by Cutaneous Blue Light Irradiation Inhibits Remote Tumor Growth and Metastasis.

ACS Pharmacol Transl Sci. 2024-3-16

[4]
Anakinra authorized to treat severe coronavirus disease 2019; Sepsis breakthrough or time to reflect?

Front Microbiol. 2023-10-19

[5]
Early Trends to Show the Efficacy of Cordyceps militaris in Mild to Moderate COVID Inflammation.

Cureus. 2023-8-18

[6]
During Sepsis and COVID-19, the Pro-Inflammatory and Anti-Inflammatory Responses Are Concomitant.

Clin Rev Allergy Immunol. 2023-10

[7]
Anxiety, depression, and memory loss in Chagas disease: a puzzle far beyond neuroinflammation to be unpicked and solved.

Mem Inst Oswaldo Cruz. 2023

[8]
Infection with SARS-CoV-2 Is Associated with Elevated Levels of IP-10, MCP-1, and IL-13 in Sepsis Patients.

Diagnostics (Basel). 2023-3-11

[9]
Unconventional secretion of unglycosylated ORF8 is critical for the cytokine storm during SARS-CoV-2 infection.

PLoS Pathog. 2023-1

[10]
Should We Interfere with the Interleukin-6 Receptor During COVID-19: What Do We Know So Far?

Drugs. 2023-1

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索