Journal
INDIAN JOURNAL OF PHARMACOLOGY
Volume 53, Issue 3, Pages 226-228Publisher
WOLTERS KLUWER MEDKNOW PUBLICATIONS
DOI: 10.4103/ijp.IJP_615_20
Keywords
COVID-19; cytokine storm; emapalumab; interferon; SARS-CoV-2
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Although various potent drugs have been used for cytokine storm, mortality remains high for COVID-19 patients in the ICU. IFNs play a key role in both primary and secondary cytokine storms, with treatments like anakinra, tocilizumab, and JAK inhibitors being effective but sometimes inadequate. Emapalumab, a potent antagonist of IFN-gamma, could be a life-saving option for cases resistant to conventional treatments.
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-gamma 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-gamma. Eb can be life saving for cytokine storm caused by COVID-19, which is resistant to anakinra, tocilizumab, and JAK inhibitors.
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