Why tocilizumab could be an effective treatment for severe COVID-19?

被引:299
作者
Fu, Binqing [1 ,2 ,3 ,4 ,5 ]
Xu, Xiaoling [5 ]
Wei, Haiming [1 ,2 ,3 ,4 ,5 ]
机构
[1] Univ Sci & Technol China, Inst Immunol, Hefei 230001, Anhui, Peoples R China
[2] Univ Sci & Technol China, CAS Key Lab Innate Immun & Chron Dis, Sch Life Sci, Hefei 230001, Anhui, Peoples R China
[3] Univ Sci & Technol China, Med Ctr, Hefei 230001, Anhui, Peoples R China
[4] Univ Sci & Technol China, Hefei Natl Lab Phys Sci Microscale, Hefei 230001, Anhui, Peoples R China
[5] Univ Sci & Technol China, Affiliated Hosp 1, Div Life Sci & Med, Hefei 230001, Anhui, Peoples R China
关键词
COVID-19; SARS-CoV-2; Acute respiratory distress syndrome (ARDS); Inflammatory storm; IL-6; Tocilizumab;
D O I
10.1186/s12967-020-02339-3
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
A severe pneumonia-associated respiratory syndrome caused by a new coronavirus was identified in December 2019 (COVID-19), spread rapidly and has become a world-wide public health challenge. About 25% of COVID-19 patients experienced severe complications including acute respiratory distress syndrome (ARDS), and even progressed into an intensive care unit (ICU) admission and died. The exploration for the mortality causes and advancing novel therapeutic development of severe COVID-19 is crucial at the moment. The biopsy samples analysis at autopsy suggested that increased alveolar exudate caused by aberrant host immune response and inflammatory cytokine storm probably impedes alveolar gas exchange and contributes to the high mortality of severe COVID-19 patients. Our research has identified that pathogenic T cells and inflammatory monocytes incite inflammatory storm with large amount of interleukin 6, therefore monoclonal antibody that targets the IL-6 pathways may potentially curb inflammatory storm. Moreover, Tocilizumab treatment that blocking IL-6 receptors showed inspiring clinical results including temperature returned to normal quickly and respiratory function improved. Therefore, we suggest that Tocilizumab is an effective treatment in severe patients of COVID-19 to calm the inflammatory storm and reduce mortality.
引用
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页数:5
相关论文
共 10 条
[1]  
[Anonymous], EFFECTIVE TREATMENT
[2]   Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology [J].
Channappanavar, Rudragouda ;
Perlman, Stanley .
SEMINARS IN IMMUNOPATHOLOGY, 2017, 39 (05) :529-539
[3]   The Cytokine GM-CSF Drives the Inflammatory Signature of CCR2+ Monocytes and Licenses Autoimmunity [J].
Croxford, Andrew L. ;
Lanzinger, Margit ;
Hartmann, Felix J. ;
Schreiner, Bettina ;
Mair, Florian ;
Pelczar, Pawel ;
Clausen, Bjoern E. ;
Jung, Steffen ;
Greter, Melanie ;
Becher, Burkhard .
IMMUNITY, 2015, 43 (03) :502-514
[4]   Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China (vol 395, pg 497, 2020) [J].
Huang, C. ;
Wang, Y. ;
Li, X. .
LANCET, 2020, 395 (10223) :496-496
[5]  
Luo W., 2020, CLIN PATHOLOGY CRITI
[6]  
Tian Sufang., 2020, Pulmonary Pathology of Early-Phase 2019 Novel Coronavirus (COVID-19) Pneumonia in Two Patients With Lung CancerJournal of Thoracic Oncology
[7]   A novel coronavirus outbreak of global health concern [J].
Wang, Chen ;
Horby, Peter W. ;
Hayden, Frederick G. ;
Gao, George F. .
LANCET, 2020, 395 (10223) :470-473
[8]   Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [J].
Wang, Dawei ;
Hu, Bo ;
Hu, Chang ;
Zhu, Fangfang ;
Liu, Xing ;
Zhang, Jing ;
Wang, Binbin ;
Xiang, Hui ;
Cheng, Zhenshun ;
Xiong, Yong ;
Zhao, Yan ;
Li, Yirong ;
Wang, Xinghuan ;
Peng, Zhiyong .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (11) :1061-1069
[9]   Pathological findings of COVID-19 associated with acute respiratory distress syndrome [J].
Xu, Zhe ;
Shi, Lei ;
Wang, Yijin ;
Zhang, Jiyuan ;
Huang, Lei ;
Zhang, Chao ;
Liu, Shuhong ;
Zhao, Peng ;
Liu, Hongxia ;
Zhu, Li ;
Tai, Yanhong ;
Bai, Chongqing ;
Gao, Tingting ;
Song, Jinwen ;
Xia, Peng ;
Dong, Jinghui ;
Zhao, Jingmin ;
Wang, Fu-Sheng .
LANCET RESPIRATORY MEDICINE, 2020, 8 (04) :420-422
[10]   Pathogenic T-cells and inflammatory monocytes incite inflammatory storms in severe COVID-19 patients [J].
Zhou, Yonggang ;
Fu, Binqing ;
Zheng, Xiaohu ;
Wang, Dongsheng ;
Zhao, Changcheng ;
Qi, Yingjie ;
Sun, Rui ;
Tian, Zhigang ;
Xu, Xiaoling ;
Wei, Haiming .
NATIONAL SCIENCE REVIEW, 2020, 7 (06) :998-1002