A cytokine storm is a hyperinflammatory state secondary to the excessive production of cytokines by a deregulated immune system. It manifests clinically as an influenza-like syndrome, which can be complicated by multi-organ failure and coagulopathy, leading, in the most severe cases, even to death. The term cytokine storm was first used in 1993 to describe the graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. It was then reused to define the adverse syndromes secondary to the administration of immunostimulating agents, such as anti-CD28 antibodies or bioengineered immune cells, i.e., CAR T-cell therapy. Currently, the concept of cytokine storm has been better elucidated and extended to the pathogenesis of many other conditions, such as sepsis, autoinflammatory disease, primary and secondary hemophagocytic lymphohistiocytosis, and multicentric Castleman disease. Moreover, cytokine storm has recently emerged as a key aspect in the novel Coronavirus disease 2019, as affected patients show high levels of several key pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, TNF-α, IFN-γ, IP-10, GM-CSF, MCP-1, and IL-10, some of which also correlate with disease severity. Therefore, since the onset of the pandemic, numerous agents have been tested in the effort to mitigate the cytokine storm in COVID-19 patients, some of which are effective in reducing mortality, especially in critically ill patients, and are now becoming standards of care, such as glucocorticoids or some cytokine inhibitors. However, the challenge is still far from being met, and other therapeutic strategies are being tested in the hope that we can eventually overcome the disease.
【저자키워드】 COVID-19, Glucocorticoids, Cytokine storm, Anakinra, Tocilizumab, Methylene blue, jak inhibitors, Plasmapheresis, 【초록키워드】 coronavirus disease, Glucocorticoids, Coronavirus disease 2019, Cytokine storm, pandemic, therapy, Cytokines, Pathogenesis, antibody, IL-6, GM-CSF, disease severity, IP-10, Sepsis, cytokine, immune system, novel coronavirus disease, glucocorticoid, Novel coronavirus, Coagulopathy, Critically ill, Patient, death, severe cases, MCP-1, immune cells, Allogeneic, pro-inflammatory cytokines, hemophagocytic lymphohistiocytosis, T-cell, Hematopoietic stem cell, Graft, IL-10, secondary hemophagocytic lymphohistiocytosis, disease, Care, IL-1, therapeutic strategy, critically ill patients, autoinflammatory disease, COVID-19 patients, IFN-γ, TNF-α, IL-2, administration, hyperinflammatory state, Hope, Graft-versus-host disease, Stem cell transplantation, stem cell, secondary to, syndrome, effort, multi-organ failure, reducing mortality, allogeneic hematopoietic stem cell transplantation, excessive production of cytokines, cytokine inhibitors, mitigate, effective, CAR, leading, tested, affected, clinically, the disease, overcome, to define, conditions, deregulated, the cytokine storm, 【제목키워드】 storm,