Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions.
Anakinra
COVID-19
Cytokine storm
IL-1
IL-6
Sars-CoV2
Tocilizumab
Type-I interferon
Journal
Autoimmunity reviews
ISSN: 1873-0183
Titre abrégé: Autoimmun Rev
Pays: Netherlands
ID NLM: 101128967
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
26
04
2020
accepted:
28
04
2020
pubmed:
8
5
2020
medline:
11
6
2020
entrez:
8
5
2020
Statut:
ppublish
Résumé
The coronavirus disease-19 pandemic (COVID-19), which appeared in China in December 2019 and rapidly spread throughout the world, has forced clinicians and scientists to take up extraordinary challenges. This unprecedented situation led to the inception of numerous fundamental research protocols and many clinical trials. It quickly became apparent that although COVID-19, in the vast majority of cases, was a benign disease, it could also develop a severe form with sometimes fatal outcomes. Cytokines are central to the pathophysiology of COVID-19; while some of them are beneficial (type-I interferon, interleukin-7), others appear detrimental (interleukin-1β, -6, and TNF-α) particularly in the context of the so-called cytokine storm. Yet another characteristic of the disease has emerged: concomitant immunodeficiency, notably involving impaired type-I interferon response, and lymphopenia. This review provides an overview of current knowledge on COVID-19 immunopathology. We discuss the defective type-I IFN response, the theoretical role of IL-7 to restore lymphocyte repertoire, as well as we mention the two patterns observed in severe COVID-19 (i.e. interleukin-1β-driven macrophage activation syndrome vs. interleukin-6-driven immune dysregulation). Next, reviewing current evidence drawn from clinical trials, we examine a number of cytokine and anti-cytokine therapies, including interleukin-1, -6, and TNF inhibitors, as well as less targeted therapies, such as corticosteroids, chloroquine, or JAK inhibitors.
Identifiants
pubmed: 32376392
pii: S1568-9972(20)30129-4
doi: 10.1016/j.autrev.2020.102567
pmc: PMC7196557
pii:
doi:
Substances chimiques
Cytokines
0
IL1B protein, human
0
IL6 protein, human
0
Interleukin-1beta
0
Interleukin-6
0
Interferons
9008-11-1
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
102567Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no conflict of interest.
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