The most critically ill COVID-19 patients are known to undergo a cytokine storm leading to poor prognosis and need urgent anti-inflammatory treatment/hospitalisation. There are many variations of this phenomenon and they go by many names: systemic inflammatory response syndrome, macrophage activation syndrome or cytokine release syndrome (CRS).
A cytokine storm is an overproduction of immune cells and their activating compounds, the cytokines. When SARS-CoV-2 enters the lungs, it triggers an immune response, attracting immune cells to the region to attack the virus, resulting in localised inflammation. But in some patients, excessive or uncontrolled levels of cytokines are released which then activate more immune cells, resulting in hyperinflammation. The resulting lung inflammation and fluid buildup can lead to respiratory distress and can be contaminated by a secondary bacterial pneumonia. This increases the risk of mortality in patients. Cytokine storms might explain why some people have a severe reaction to coronaviruses while others only experience mild symptoms. They could also be the reason why younger people are less affected, as their immune systems are less developed and so produce lower levels of inflammation-driving cytokines. Cytokine storms are a common complication not only of COVID-19 and flu but of other respiratory diseases caused by coronaviruses such as SARS and MERS. They are also associated with non-infectious diseases such as multiple sclerosis and pancreatitis.
Therefore the diagnostic detection and treatment of cytokine storms has become an important part of rescuing severe patients. Targets like IL-1, IL-6, IL-7, IL-10, IL-18, IL-33, IFN-γ, TNF-α or many others might play an important role in cytokine release syndrome (CRS). Detection of their levels and blockage of their signalling pathways with immunomodulatory agents (biologicals, small molecules) is expected to become a new method for the treatment of severe patients.
AdipoGen Life Sciences offers Cytokine Immunoassays as well as recombinant cytokines and blocking antibodies, which are already being successfully used to research the various cytokine storm factors involved and to characterise the immune response.
LITERATURE REFERENCES:
- COVID-19: consider cytokine storm syndromes and immunosuppression: P. Mehta, et al. ; The Lancet 395, p1033 (2020)
- The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality: C. Zhang, et al. ; Int. J. Antimicrob. Agents (Epub ahead of print) (2020)
Selected Biologicals for Cytokine Storm Research
Originally posted on adipogen.com/covid-19
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