Open AccessSevere acute respiratory syndrome coronavirus 2 infection: Role of interleukin-6 and the inflammatory cascade
Author(s) -
Mohaddeseh Bahmani,
Rojin Chegini,
Elham Ghanbari,
Hossein Bannazadeh Baghi,
Parisa Shiri Aghbash,
Hamed Ebrahimzadeh Leylabadlo,
Ehsan Moradian,
Amir Masoud Kazemzadeh Houjaghan,
Hossein Bannazadeh Baghi
Publication year - 2022
Publication title -
world journal of virology
Language(s) - English
Resource type - Journals
ISSN - 2220-3249
DOI - 10.5501/wjv.v11.i3.113
Subject(s) - tocilizumab , medicine , janus kinase , immunology , glycoprotein 130 , cytokine storm , cytokine release syndrome , interleukin 6 , coronavirus , cytokine , immune system , disease , pathogenesis , infectious disease (medical specialty) , covid-19 , rheumatoid arthritis , immunotherapy , chimeric antigen receptor
Since December 2019, a novel coronavirus that represents a serious threat to human lives has emerged. There is still no definite treatment for severe cases of the disease caused by this virus, named coronavirus disease 2019 (COVID-19). One of the most considered treatment strategies targets the exaggerated immune regulator, and interleukin (IL)-6 is a crucial pro-inflammatory mediator. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases show an elevated level of IL-6 related to disease severity. IL-6 activity can be inhibited by the following: IL-6 itself, IL-6 signaling pathways such as Janus kinase and signal transducer and activator of transcription (JAK-STAT), gp130, IL-6R, and downstream activated ILs, such as IL-17 and IL-6 cytokine. Currently, according to these studies and their results, IL-6 blockade with anti-IL-6 or its receptor antibodies such as tocilizumab in COVID-19 is beneficial in severe cases and may reduce the mortality rate. JAK-STAT inhibitors block the cytokine storm by inhibiting several crucial pro-inflammatory mediators such as TNF-α and IL-6 and have shown various results in clinical trials. IL-6 induces IL-17 secretion, and IL-17 is involved in the pathogenesis of inflammatory processes. Clinical trials of anti-IL-17 drugs are currently recruiting, and anti-gp130 antibody is preclinical. However, this agent has shown positive effects in inflammatory bowel disease clinical trials and could be tested for SARS-CoV-2. This study aimed to review the role of IL-6 in the cytokine storm and studies regarding IL-6 and blockade of its inflammatory pathways in COVID-19 to determine if any of these agents are beneficial for COVID-19 patients.