The Society for Immunotherapy of Cancer perspective on regulation of interleukin-6 signaling in COVID-19-related systemic inflammatory response
Open Access
- 20 December 2019
- journal article
- research article
- Published by BMJ in Journal for ImmunoTherapy of Cancer
- Vol. 8 (1), e000930
- https://doi.org/10.1136/jitc-2020-000930
Abstract
The pandemic caused by the novel coronavirus SARS-CoV-2 has placed an unprecedented burden on healthcare systems around the world. In patients who experience severe disease, acute respiratory distress is often accompanied by a pathological immune reaction, sometimes referred to as ‘cytokine storm’. One hallmark feature of the profound inflammatory state seen in patients with COVID-19 who succumb to pneumonia and hypoxia is marked elevation of serum cytokines, especially interferon gamma, tumor necrosis factor alpha, interleukin 17 (IL-17), interleukin 8 (IL-8) and interleukin 6 (IL-6). Initial experience from the outbreaks in Italy, China and the USA has anecdotally demonstrated improved outcomes for critically ill patients with COVID-19 with the administration of cytokine-modulatory therapies, especially anti-IL-6 agents. Although ongoing trials are investigating anti-IL-6 therapies, access to these therapies is a concern, especially as the numbers of cases worldwide continue to climb. An immunology-informed approach may help identify alternative agents to modulate the pathological inflammation seen in patients with COVID-19. Drawing on extensive experience administering these and other immune-modulating therapies, the Society for Immunotherapy of Cancer offers this perspective on potential alternatives to anti-IL-6 that may also warrant consideration for management of the systemic inflammatory response and pulmonary compromise that can be seen in patients with severe COVID-19.This publication has 102 references indexed in Scilit:
- Janus kinase inhibitors in autoimmune diseasesAnnals Of The Rheumatic Diseases, 2013
- IL-1 and T Helper Immune ResponsesFrontiers in Immunology, 2013
- Decoys and Regulatory “Receptors” of the IL-1/Toll-Like Receptor SuperfamilyFrontiers in Immunology, 2013
- Treating inflammation by blocking interleukin-1 in a broad spectrum of diseasesNature Reviews Drug Discovery, 2012
- Targeting the Interleukin-6/Jak/Stat Pathway in Human MalignanciesJournal of Clinical Oncology, 2012
- Into the Eye of the Cytokine StormMicrobiology and Molecular Biology Reviews, 2012
- Immunology in clinic review series; focus on autoinflammatory diseases: update on monogenic autoinflammatory diseases: the role of interleukin (IL)-1 and an emerging role for cytokines beyond IL-1Clinical and Experimental Immunology, 2012
- Interleukin-1 in the pathogenesis and treatment of inflammatory diseasesBlood, 2011
- Severe Acute Respiratory Syndrome (SARS) Coronavirus-Induced Lung Epithelial Cytokines Exacerbate SARS Pathogenesis by Modulating Intrinsic Functions of Monocyte-Derived Macrophages and Dendritic CellsJournal of Virology, 2009
- Tumor Necrosis Factor Alpha Protects against Lethal West Nile Virus Infection by Promoting Trafficking of Mononuclear Leukocytes into the Central Nervous SystemJournal of Virology, 2008