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托珠单抗在 SARS-CoV-2 诱导的细胞因子风暴中的治疗作用:原理和现有证据。

Therapeutic Role of Tocilizumab in SARS-CoV-2-Induced Cytokine Storm: Rationale and Current Evidence.

机构信息

Department of Health Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy.

Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.

出版信息

Int J Mol Sci. 2021 Mar 17;22(6):3059. doi: 10.3390/ijms22063059.

Abstract

Among patients suffering from coronavirus disease 2019 (COVID-19) syndrome, one of the worst possible scenarios is represented by the critical lung damage caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-induced cytokine storm, responsible for a potentially very dangerous hyperinflammatory condition. Within such a context, interleukin-6 (IL-6) plays a key pathogenic role, thus being a suitable therapeutic target. Indeed, the IL-6-receptor antagonist tocilizumab, already approved for treatment of refractory rheumatoid arthritis, is often used to treat patients with severe COVID-19 symptoms and lung involvement. Therefore, the aim of this review article is to focus on the rationale of tocilizumab utilization in the SARS-CoV-2-triggered cytokine storm, as well as to discuss current evidence and future perspectives, especially with regard to ongoing trials referring to the evaluation of tocilizumab's therapeutic effects in patients with life-threatening SARS-CoV-2 infection.

摘要

在患有 2019 冠状病毒病(COVID-19)综合征的患者中,最糟糕的情况之一是由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的细胞因子风暴导致的严重肺部损伤,这可能导致非常危险的过度炎症状态。在这种情况下,白细胞介素 6(IL-6)起着关键的致病作用,因此是一个合适的治疗靶点。事实上,IL-6 受体拮抗剂托珠单抗已被批准用于治疗难治性类风湿关节炎,常用于治疗有严重 COVID-19 症状和肺部受累的患者。因此,本文的目的是集中讨论在 SARS-CoV-2 引发的细胞因子风暴中使用托珠单抗的原理,以及讨论当前的证据和未来的前景,特别是关于正在进行的试验,这些试验涉及评估托珠单抗对有生命危险的 SARS-CoV-2 感染患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc0/8002419/64e8954a562e/ijms-22-03059-g001.jpg

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