恩巴鲁单抗可否为对阿那白滞素、托珠单抗和 Janus 激酶抑制剂耐药的 COVID-19 引起的难治性、复发性和进行性细胞因子风暴患者赢得一线生机？
Can emapalumab be life saving for refractory, recurrent, and progressive cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and Janus kinase inhibitors.
机构信息
Department of Internal Medicine, Ota and Jinemed Hospital, Istanbul, Turkey.
Department of Rheumatology, Meram Tip Faculty, Necmettin Erbakan University, Konya, Turkey.
出版信息
Indian J Pharmacol. 2021 May-Jun;53(3):226-228. doi: 10.4103/ijp.IJP_615_20.
Although many potent drugs have been used for cytokine storm, mortality is high for patients with coronavirus disease-2019 (COVID-19), which is followed up in the intensive care unit. Interferons (IFNs) are the major cytokines of the antiviral defense system released from many cell types. However, IFN-γ plays a key role in both primary and secondary cytokine storms. If the cytokine storm is not treated urgently, it will be fatal; therefore, it should be treated immediately. Anakinra, an interleukin-1 (IL-1) antagonist, tocilizumab, an IL-6 antagonist, and Janus kinase (JAK) inhibitors are successfully used in cytokine storm caused by COVID-19. However, sometimes, despite these treatments, the patient's clinical course does not improve. Emapalumab (Eb) is the human immunoglobulin G1 monoclonal antibody and is a potent and noncompetitive antagonist of IFN-γ. Eb can be life saving for cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and JAK inhibitors.
虽然有许多强效药物可用于治疗细胞因子风暴，但在重症监护病房中接受治疗的 2019 年冠状病毒病（COVID-19）患者死亡率仍然很高。干扰素（IFN）是许多细胞类型释放的抗病毒防御系统的主要细胞因子。然而，IFN-γ 在原发性和继发性细胞因子风暴中都发挥着关键作用。如果不紧急治疗细胞因子风暴，将是致命的；因此，应立即进行治疗。白细胞介素-1（IL-1）拮抗剂阿那白滞素、IL-6 拮抗剂托珠单抗和 Janus 激酶（JAK）抑制剂已成功用于 COVID-19 引起的细胞因子风暴。然而，有时尽管进行了这些治疗，患者的临床病程仍未改善。Emapalumab（Eb）是人免疫球蛋白 G1 单克隆抗体，是 IFN-γ 的有效且非竞争性拮抗剂。对于对抗生素、托珠单抗和 JAK 抑制剂耐药的 COVID-19 引起的细胞因子风暴，Eb 可以挽救生命。
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