Cytokine Storm and Severity of COVID-19

The most critically ill COVID-19 patients are known to undergo a cytokine storm leading to poor prognosis and need of urgent anti-inflammatory treatment/hospitalization. There are many variations on this phenomenon and they go by many names: systemic inflammatory response syndrome, macrophage activation syndrome or cytokine release syndrome (CRS).

A cytokine storm is an overproduction of immune cells and their activating compounds, the cytokines.  When SARS-CoV-2 enters the lungs, it triggers an immune response, attracting immune cells to the region to attack the virus, resulting in localized inflammation. But in some patients, excessive or uncontrolled levels of cytokines are released which then activate more immune cells, resulting in hyperinflammation. The resulting lung inflammation and fluid buildup can lead to respiratory distress and can be contaminated by a secondary bacterial pneumonia. This increases the risk of mortality in patients. Cytokine storms might explain why some people have a severe reaction to coronaviruses while others only experience mild symptoms. They could also be the reason why younger people are less affected, as their immune systems are less developed and so produce lower levels of inflammation-driving cytokines. Cytokine storms are a common complication not only of COVID-19 and flu but of other respiratory diseases caused by coronaviruses such as SARS and MERS. They are also associated with non-infectious diseases such as multiple sclerosis and pancreatitis.

Therefore the diagnostic detection and treatment of cytokine storms has become an important part of rescuing severe patients. Targets like IL-1, IL-6, IL-7, IL-10, IL-18, IL-33, IFN-γ, TNF-α or many others might play an important role in cytokine release syndrome (CRS). Detection of their levels and blockage of their signaling pathways with immunomodulatory agents (biologicals, small molecules) is expected to become a new method for the treatment of severe patients.

AdipoGen Life Sciences offers a broad range of Cytokine Immunoassays as well as recombinant cytokines and blocking antibodies, which are already being successfully used to research the various cytokine storm factors involved and to characterize the immune response.

LITERATURE REFERENCES:

  1. COVID-19: consider cytokine storm syndromes and immunosuppression: P. Mehta, et al. ; The Lancet 395, p1033 (2020)
  2. The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality: C. Zhang, et al. ; Int. J. Antimicrob. Agents (Epub ahead of print) (2020)

Selected Biologicals for Cytokine Storm Research

TargetProduct NamePID
Interleukin-6Cymax IL-6 (human) ELISA KitYIF-LF-EK0260
IL-6 (human):Fc (human) (rec.)CHI-HF-21006
Interleukin-1 Family / InflammasomeIL-1? (human) (rec.) (untagged)AG-40B-0023
Cymax IL-1? (human) ELISA KitYIF-LF-EK0276
anti-NLRP3/NALP3, mAb (Cryo-2)AG-20B-0014
anti-Caspase-1 (p20) (human), mAb (Bally-1)AG-20B-0048
Interleukin-33IL-33 (human) (rec.) (untagged)AG-40B-0038
IL-33 (oxidation resistant) (human) (rec.) (His)AG-40B-0167
IL-33 (oxidation resistant) (human) (rec.) (untagged)AG-40B-0160
anti-IL-33 (human), mAb (IL33305B)AG-20A-0041
anti-IL-33 (mouse), mAb (rec.) (blocking) (Bondy-1-1) (PF)AG-27B-0013PF
IL-33 (human) ELISA KitAG-45A-0033YEK
GM-CSFGM-CSF (human) (rec.) (His)CHI-HR-200CSF
Interleukin-2IL-2 (human) (rec.) (untagged)CHI-HR-20602
IL-2 Superkine (Fc)AG-40B-0111
IL-2 Superkine (untagged)AG-40B-0187
TNF-?TNF-?, Soluble (human) (rec.)AG-40B-0006
TNF-? (human) (multimeric) (rec.)AG-40B-0019
anti-TNF-? (human), mAb (J1D9)ANC-398-020
anti-TNF-? (mouse), mAb (blocking) (V1q) (PF)AG-20B-0081PF
Interleukin-10IL-10 (human) (rec.) (untagged)CHI-HR-20610
IL-10 (human):Fc (human) (rec.) (non-lytic)CHI-HF-22010
Cytokine Storm and Severity of COVID-19