The role of cytokines and their antagonists in the treatment of COVID‐19 patients
Zeinab Mohseni Afshar, Mohammad Barary, Arefeh Babazadeh, Ali Tavakoli Pirzaman, Rezvan Hosseinzadeh, Amirmasoud Alijanpour, Amirreza Allahgholipour, Seyed Rouhollah Miri, Terence T. Sio, Mark J. M. Sullman, Kristin Carson‐Chahhoud, Soheil Ebrahimpour
Abstract
The coronavirus disease 2019 (COVID-19) has various presentations, of which immune dysregulation or the so-called cytokine storm syndrome (COVID-CSS) is prominent. Even though cytokines are vital regulators of body immunoinflammatory responses, their exaggerated release can be harmful. This hyperinflammatory response is more commonly observed during severe COVID-19 infections, caused by the excessive release of pro-inflammatory cytokines, such as interleukin-1 (IL-1), IL-6, IL-8, tumour necrosis factor, granulocyte-macrophage colony-stimulating factor, and interferon-gamma, making their blockers and antagonists of great interest as therapeutic options in this condition. Thus, the pathophysiology of excessive cytokine secretion is outlined, and their most important blockers and antagonists are discussed, mainly focussing on tocilizumab, an interleukin-6 receptor blocker approved to treat severe COVID-19 infections.