Pharmacologic Modulation during Cytokine Storm in COVID-19

Authors

  • Luiza Gabunia Tbilisi State Medical University, Georgia, Tbilisi, Georgia
  • Shrena Khetsuriani Tbilisi State Medical University, Georgia, Tbilisi, Georgia
  • Natia Gamkrelidze Tbilisi State Medical University, Georgia, Tbilisi, Georgia
  • Levan Ratiani The First University Clinic, Georgia, Tbilisi, Georgia
  • Natalia Filipets Bukovinian State Medical University, Chernivtsi, Ukraine
  • Levan Metreveli University of Georgia, School of Health Sciences, Tbilisi, Georgia
  • Nodar Sulashvili Tbilisi State Medical University, Georgia, Tbilisi, Georgia, Tbilisi Open University, Tbilisi, Georgia
  • Natia Antia Tbilisi State Medical University, Georgia, Tbilisi, Georgia

Keywords:

COVID-19 infection, SARS-CoV-2, cytokine storm, anti-inflammatory therapy, ytokine-targeted therapy

Abstract

The novel Coronavirus -SARS-CoV-2 activates macrophages in order to liberate cytokines into the bloodstream. Inflammatory cytokine secretion increases producing cytokine storm. In this phase significant lymphopenia occurs. Cytokine storm in response to the viral infection can result in sepsis.  Ferritin is an important indicator of immune dysregulation, extreme hyperferritinemia, via direct immune-suppressive and proinflammatory effects, contributes to the cytokine storm.There are discussed some clinical evidences that indicate the importance of anti-inflammatory and cytokine-targeted therapies.These approaches are: inhibition of IL-1, IL-6, TNF-? and IFN-?.  Alternative treatments for cytokine storm - therapeutic plasma exchange and the mode of action of colchicine, glucocorticoids, and intravenous immunoglobulin - are also discussed. Convalescent plasma, anti-inflammatory treatment, together with anti-viral therapy becomes an essential part of treatment for COVID-19 infection.

 

References

. Costela-Ruiz VJ, Illescas-Montes R, Puerta-Puerta JM, Ruiz C, Melguizo-Rodríguez L. SARS-CoV-2 infection: The role of cytokines in COVID-19 disease. Cytokine & growth factor reviews. 2020; 1(54):62-75

. Filippo, Cattaneo Gaetano Maria, Capelli Patrizio Serum ferritin levels in inflammation: a retrospective comparative analysis between COVID-19 and emergency surgical non-COVID-19 patients. World Journal of Emergency Surgery. 2021; 16:9

. Cavezzi A., et al. COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review Clin. Pract. (2020), 10.4081/cp.2020.1271

. EvangelosTerpos, IoannisNtanasis‐Stathopoulos, Ismail Elalamy, EfstathiosKastritis et al Hematological findings and complications of COVID‐19. AmJHematol. 2020; 95:834-847

. Emami A., Javanmardi F., Pirbonyeh N., Akbari A. Prevalence of underlying diseases in hospitalized patients with COVID-19: a systematic review and meta-analysis. Arch. Acad. Emerg. Med. 2020; 8

. Mehta P., McAuley D.F., Brown M., Sanchez E., Tattersall R.S., Manson J.J. COVID- 19: consider cytokine storm syndromes and immunosuppression. Lancet (London, England). 2020; 395:1033-1034

. Marcelo Maia Pinheiro, Andrea Fabbri , Marco Infante . Cytokine storm modulation in COVID-19: a proposed role for vitamin D and DPP-4 inhibitor combination therapy (VIDPP-4i)April 2021 Immunotherapy 13(7); PMC - PubMed;DOI: 10.2217/imt-2020-0349

. Yang L, Liu S, Liu J et al. COVID-19: immunopathogenesis and immunotherapeutics. Signal Transduct. Target. Ther. 2020; 5(1):128

. Cavalli G, De Luca G, Campochiaro C, Della-Torre E, Ripa M, Canetti D. et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020; 2(6):e325-e31 doi: 10.1016/S2665-9913(20)30127-2

. Campochiaro C, Della-Torre E, Cavalli G, De Luca G, Ripa M, Boffini N. et al. Efficacy and safety of tocilizumab in severe COVID-19 patients: a single-centre retrospective cohort study. Eur J Intern Med. 2020; 76:43-9

. Lai W, Wang J, Huang B, Lin EP, Yang P. A novel TNF-α-targeting aptamer for TNF-α-mediated acute lung injury and acute liver failure. Theranostics. 2019; 9(6):1741-51]

. Acharya D, Liu G, Gack MU. Dysregulation of type I interferone responses in COVID-19. Nat Rev Immunol. 2020; 20(7):397-8

. Shang L, Zhao J, Hu Y, Du R, Cao B. On the use of corticosteroids for 2019-nCoV pneumonia. Lancet. 2020; 395(10225):683-470;

. Bosnak M, Erdogan S, Aktekin EH, Bay A. Therapeutic plasma exchange in primary hemophagocyticlymphohistiocytosis: Reports of two cases and a review of the literature. TransfusApher Sci. 2016; 55(3):353-6

Downloads

Published

2021-11-18

How to Cite

Luiza Gabunia, Shrena Khetsuriani, Natia Gamkrelidze, Levan Ratiani, Natalia Filipets, Levan Metreveli, Nodar Sulashvili, & Natia Antia. (2021). Pharmacologic Modulation during Cytokine Storm in COVID-19 . International Journal of Applied Sciences: Current and Future Research Trends, 12(1), 7–12. Retrieved from https://ijascfrtjournal.isrra.org/index.php/Applied_Sciences_Journal/article/view/1179

Issue

Section

Articles