Perelman School of Medicine, University of Pennsylvania, Pediatric Rheumatology and Immune Dysregulation, The Childrens Hospital of Philadelphia, Philadelphia, PA, USA.
Division of Rheumatology and Immune Dysregulation Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Adv Exp Med Biol. 2024;1448:385-397. doi: 10.1007/978-3-031-59815-9_26.
Cytokine Storm is a complex and heterogeneous state of life-threatening systemic inflammation and immunopathology. Autoinflammation is a mechanistic category of immune dysregulation wherein immunopathology originates due to poor regulation of innate immunity. The growing family of monogenic Systemic Autoinflammatory Diseases (SAIDs) has been a wellspring for pathogenic insights and proof-of-principle targeted therapeutic interventions. There is surprisingly little overlap between SAID and Cytokine Storm Syndromes, and there is a great deal to be inferred from those SAID that do, and do not, consistently lead to Cytokine Storm. This chapter will summarize how illustrations of the autoinflammatory paradigm have advanced the understanding of human inflammation, including the role of autoinflammation in familial HLH. Next, it will draw from monogenic SAID, both those with strong associations with cytokine storm and those without, to illustrate how the cytokine IL-18 links innate immune dysregulation and cytokine storm.
细胞因子风暴是一种危及生命的全身炎症和免疫病理的复杂且异质状态。自身炎症是一种免疫失调的机制类别,其中免疫病理学由于先天免疫调节不良而起源。不断增加的单基因系统性自身炎症性疾病(SAID)家族为发病机制的深入了解和基于原理的靶向治疗干预提供了源泉。SAID 和细胞因子风暴综合征之间的重叠很少,并且可以从确实并且确实不会始终导致细胞因子风暴的那些 SAID 中推断出很多。本章将总结自身炎症范例的说明如何促进了对人类炎症的理解,包括自身炎症在家族性 HLH 中的作用。接下来,它将从具有强烈细胞因子风暴关联的单基因 SAID 和没有关联的 SAID 中汲取例证,说明先天免疫失调和细胞因子风暴之间的联系。