Interleukin-6 blocking therapy for COVID-19: From immune pathogenesis to clinical outcomes.

Rheumatology and immunology research Pub Date : 2022-04-20 eCollection Date: 2022-03-01 DOI:10.2478/rir-2022-0002
Fan Xiao, Ling Wu, Xiaoxia Zhu, Lijun Zhang, Dongzhou Liu, Lijun Wu, Hejian Zou, Liwei Lu
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Abstract

As a newly emerged infectious disease, the coronavirus disease 2019 (COVID-19) has caused millions of deaths, resulting in a global health challenge. Currently, several vaccines have been approved with significant benefits against disease transmission. However, effective therapies are still needed for the clinical management of infected COVID-19 patients. Available evidence has indicated elevated levels of proinflammatory cytokines, including interleukin-6 (IL-6), in COVID-19 patients, with cytokine storm involving excessive cytokine release being observed in some severe cases. Several clinical studies have shown the promising effects of IL-6-blocking strategy in treating severe COVID-19 patients, but some observational studies have reported that IL-6-blocking therapy has no effects in preventing disease progression or death among COVID-19 patients. Herein, we review recent findings on the immunopathogenesis of COVID-19, with specific emphasis on the proinflammatory function of IL-6 and discuss the therapeutic potential of IL-6-blocking therapy for the treatment of COVID-19 patients, especially those with rheumatic diseases.

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白细胞介素-6阻断疗法治疗COVID-19:从免疫发病机制到临床结果
作为一种新出现的传染病,冠状病毒病 2019(COVID-19)已造成数百万人死亡,给全球健康带来了挑战。目前,已有多种疫苗获得批准,对防止疾病传播有显著效果。然而,临床治疗 COVID-19 感染者仍然需要有效的疗法。现有证据表明,COVID-19 患者体内促炎细胞因子(包括白细胞介素-6 (IL-6))水平升高,在一些严重病例中还观察到细胞因子过度释放的细胞因子风暴。多项临床研究表明,IL-6 阻断策略在治疗重症 COVID-19 患者方面具有良好的效果,但也有观察性研究报告称,IL-6 阻断疗法在预防 COVID-19 患者疾病进展或死亡方面没有效果。在此,我们回顾了有关 COVID-19 免疫发病机制的最新研究成果,特别强调了 IL-6 的促炎功能,并讨论了 IL-6 阻断疗法在治疗 COVID-19 患者,尤其是风湿性疾病患者方面的治疗潜力。
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