Center for Cytokine Storm Treatment & Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
Adv Exp Med Biol. 2024;1448:459-467. doi: 10.1007/978-3-031-59815-9_31.
As described throughout this book, different triggers can elicit a variety of different cytokine storm disorders that share overlapping clinical features (Fig. 31.1). Even within a particular cytokine storm disorder, multiple different triggers can elicit the syndrome. Like HLH, multicentric Castleman disease (MCD) serves as a great example of this as it can be caused by a viral infection, neoplastic cell population, or an unknown cause. Furthermore, the idiopathic subtype of MCD (iMCD) provides one of the first examples of a cytokine storm disorder that could be abrogated with targeted neutralization of a single cytokine when inhibition with the anti-interleukin-6 (IL-6) receptor monoclonal antibody tocilizumab was shown to effectively treat iMCD in the 1990s. Of course, this "iMCD treatment," tocilizumab, has been used in a variety of cytokine storm settings over the last 30+ years.
如本书所述，不同的触发因素可引发多种具有重叠临床特征的细胞因子风暴疾病（图 31.1）。即使在特定的细胞因子风暴疾病中，也可能由多种不同的触发因素引发综合征。与 HLH 一样，多中心 Castleman 病（MCD）就是一个很好的例子，因为它可由病毒感染、肿瘤细胞群或未知原因引起。此外，MCD 的特发性亚型（iMCD）提供了细胞因子风暴疾病的首个范例之一，当在 20 世纪 90 年代证明靶向中和单种细胞因子（白细胞介素 6 [IL-6] 受体单克隆抗体托珠单抗）可阻断 iMCD 时，iMCD 可能被消除。当然，这种“iMCD 治疗”，即托珠单抗，在过去 30 多年中已在多种细胞因子风暴环境中使用。
