COVID-19, haemophagocytic lymphohistiocytosis, and infection-induced cytokine storm syndromes

Recent research in COVID-19 cytokine storm syndrome and Castleman disease has expanded the concept of pathological immune activation and established important principles applicable to other infection-induced cytokine storms.2 First, key cytokines and chemokines driving the pathological process can b...

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Bibliographic Details
Published in:The Lancet infectious diseases 2022-07, Vol.22 (7), p.937-938
Main Authors: Spaner, Caroline, Goubran, Mariam, Setiadi, Audi, Chen, Luke Y C
Format: Article
Language:English
Subjects:
Antiinfectives and antibacterials
Bone marrow
Castleman's disease
Cell activation
Chemokines
Coronaviruses
Correspondence
COVID-19
Cytokine storm
Cytokines
Cytomegalovirus
Depletion
Disease
Disorders
Epstein-Barr virus
Herpes viruses
HIV
Human immunodeficiency virus
Immune response
Immunomodulation
Infections
Infectious diseases
Inhibition
Inhibitors
Interleukin 1
Interleukin 1 receptor antagonist
Interleukin 18
Interleukin 6
Lymphocytes B
Macrophages
Parasites
Patients
Rituximab
Severe acute respiratory syndrome coronavirus 2
Tuberculosis
Viral diseases
Viruses
γ-Interferon
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Summary:Recent research in COVID-19 cytokine storm syndrome and Castleman disease has expanded the concept of pathological immune activation and established important principles applicable to other infection-induced cytokine storms.2 First, key cytokines and chemokines driving the pathological process can be identified, and inhibiting these cytokines can improve outcomes (table). [...]immunomodulation in cytokine storms can be beneficial even in the absence of effective antimicrobial therapies. Microbe Key cytokines or chemokines Targeted therapies COVID-19 cytokine storm SARS-CoV-2 IL-6 IL-6 inhibitors (tocilizumab) and JAK inhibition (baricitinib) Human herpes virus-8-positive Castleman disease HIV and human herpes virus-8 IL-6 and CXCL-13 IL-6 inhibitors (siltuximab) and B-cell depletion (rituximab) Primary haemophagocytic lymphohistiocytosis Various (eg, Epstein-Barr virus and cytomegalovirus) IFNγ and CXCL-9 IFNγ inhibition (emapalumab) and JAK inhibition (ruxolitinib) Secondary haemophagocytic lymphohistiocytosis or macrophage activation syndrome Various (eg, Mycobacterium tuberculosis, Leishmania parasites, and Bartonella spp) IL-1, IL-6, IL-18, and IFNγ IL-1 inhibition (anakinra), IL-6 inhibition (tocilizumab), and JAK inhibition (ruxolitinib) Table Infection-induced cytokine storm syndromes
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(22)00348-6