A number of mechanisms have been proposed for the development of Cytokine Release Syndrome (CRS) upon SARS-CoV-2 infection, such as NF-?B activation, anomalies in the IL-6 receptor (IL-6R), delayed response of IFNs, and antibody dependent enhancement, etc. Despite that the pathogenesis is not fully understood, appropriate control of CRS is believed to be beneficial to the outcomes of COVID-19 patients. Particularly, elevated IL-6 level was found to correlate with respiratory failure, Acute Respiratory Distress Syndrome (ARDS), disease severity and mortality in patients, giving rise to the possibility of targeting excessive inflammation caused by IL-6-IL-6R signaling to treat such disease.
Indeed, several clinical trials across the world have suggested that tocilizumab, an IL-6R monoclonal antibody approved by the U.S. FDA for the treatment of CAR-T cell therapy-induced CRS, appeared to exhibit benefits in severe COVID-19 patients, in terms of reduction in hospitalization time and in-hospital mortality as well as increased number of organ support-free days. In addition to tocilizumab, different therapies targeting inflammation and cytokine release have also been tested in treating COVID-19, such as sarilumab, baricitinib, anakinra, glucocorticoids, chloroquine, and hydroxychloroquine, many of them exhibited beneficial effects in clinics. There is no doubt that management of CRS represents a promising strategy to improve the outcomes of COVID-19 patients.
To provide the readers with a better understanding of the pathogenesis and potential therapies of COVID-19, the current theme focuses on the mechanisms by which SARS-CoV-2 infection induces CRS as well as the means to control CRS in patients. To this end, the topics of particular interest include, but are not limited to the following:
1) Clinical observations related to CRS in COVID-19 patients;
2) Mechanisms contributing to the induction of CRS by SARS-CoV-2 infection;
3) Pre-clinical findings to test the means to control CRS related to COVID-19;
4) Clinical studies to evaluate the beneficial effects of therapies targeting CRS in COVID-19 patients
A number of mechanisms have been proposed for the development of Cytokine Release Syndrome (CRS) upon SARS-CoV-2 infection, such as NF-?B activation, anomalies in the IL-6 receptor (IL-6R), delayed response of IFNs, and antibody dependent enhancement, etc. Despite that the pathogenesis is not fully understood, appropriate control of CRS is believed to be beneficial to the outcomes of COVID-19 patients. Particularly, elevated IL-6 level was found to correlate with respiratory failure, Acute Respiratory Distress Syndrome (ARDS), disease severity and mortality in patients, giving rise to the possibility of targeting excessive inflammation caused by IL-6-IL-6R signaling to treat such disease.
Indeed, several clinical trials across the world have suggested that tocilizumab, an IL-6R monoclonal antibody approved by the U.S. FDA for the treatment of CAR-T cell therapy-induced CRS, appeared to exhibit benefits in severe COVID-19 patients, in terms of reduction in hospitalization time and in-hospital mortality as well as increased number of organ support-free days. In addition to tocilizumab, different therapies targeting inflammation and cytokine release have also been tested in treating COVID-19, such as sarilumab, baricitinib, anakinra, glucocorticoids, chloroquine, and hydroxychloroquine, many of them exhibited beneficial effects in clinics. There is no doubt that management of CRS represents a promising strategy to improve the outcomes of COVID-19 patients.
To provide the readers with a better understanding of the pathogenesis and potential therapies of COVID-19, the current theme focuses on the mechanisms by which SARS-CoV-2 infection induces CRS as well as the means to control CRS in patients. To this end, the topics of particular interest include, but are not limited to the following:
1) Clinical observations related to CRS in COVID-19 patients;
2) Mechanisms contributing to the induction of CRS by SARS-CoV-2 infection;
3) Pre-clinical findings to test the means to control CRS related to COVID-19;
4) Clinical studies to evaluate the beneficial effects of therapies targeting CRS in COVID-19 patients