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Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions

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

Year of Publication: 2020
Contained in: Autoimmunity reviews Vol. 19, No. 7 (2020), p. 102567
All journal articles: Search for all articles in this journal
Language: English
Contributors: Jamilloux, Yvan | Author
Henry, Thomas
Belot, Alexandre
Viel, Sébastien
Fauter, Maxime
El Jammal, Thomas
Walzer, Thierry
François, Bruno
Sève, Pascal
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: 9008-11-1
Anakinra
COVID-19
Cytokine storm
IL-1
IL-6
IL1B protein, human
IL6 protein, human
Journal Article
Review
Sars-CoV2
Tocilizumab
Type-I interferon
Additional Keywords: Betacoronavirus
Coronavirus Infections
Cytokines
Humans
Interferons
Interleukin-1beta
Interleukin-6
Pandemics
Pneumonia, Viral
ISSN: 1873-0183
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Completed 10.06.2020
Date Revised 10.06.2020
published: Print-Electronic
Citation Status MEDLINE
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
PMID:
    32376392
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1016/j.autrev.2020.102567
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