The cytokine storm of COVID-19: a spotlight on prevention and protection
| Autor: | Derek M. Yellon, Lucie Pearce, Sean M. Davidson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Multiple Organ Failure Pneumonia Viral Clinical Biochemistry Endothelial activation 03 medical and health sciences Betacoronavirus Mice 0302 clinical medicine Pandemic Drug Discovery Medicine Animals Humans Pandemics Pharmacology biology business.industry SARS-CoV-2 COVID-19 medicine.disease biology.organism_classification Virology Patient Care Management Cytokine release syndrome Disease Models Animal 030104 developmental biology 030220 oncology & carcinogenesis Critical illness Molecular Medicine business Cytokine storm Coronavirus Infections Cytokine Release Syndrome Signal Transduction |
| Zdroj: | Expert Opinion on Therapeutic Targets |
| ISSN: | 1744-7631 1472-8222 |
| DOI: | 10.1080/14728222.2020.1783243 |
| Popis: | The cytokine release syndrome (CRS) of COVID-19 is associated with the development of critical illness requiring multi-organ support. Further research is required to halt progression of multi-organ injury induced by hyper-inflammation.PubMed/MEDLINEOver-activity of chemotaxis triggers a macrophage activation syndrome (MAS) resulting in the release of pro-inflammatory cytokines. IL-6 and TNF- α are at the forefront of hyper-inflammation. The inflammatory cascade induces endothelial activation and capillary leak, leading to circulatory collapse and shock. As endothelial dysfunction persists, there is activation of the clotting cascade and microvascular obstruction. Continued endothelial activation results in multi-organ failure, regardless of pulmonary tissue damage. We propose that targeting the endothelium may interrupt this cycle. Immuno-modulating therapies have been suggested, however, further data is necessary to confirm that they do not jeopardize adaptive immunity. Inhibition of IL-6 and the Janus Kinase, signal transducer and activator of transcription proteins pathway (JAK/STAT), are favorable targets. Remote ischemic conditioning (RIC) reduces the inflammation of sepsis in animal models and should be considered as a low risk intervention, in combination with cardiovascular protection. |
| Databáze: | OpenAIRE |
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