20.500.12556/RUL-167824 The immunopathogenesis of a cytokine storm the key mechanisms underlying severe COVID-19 A cytokine storm is marked by excessive pro-inflammatory cytokine release, and has emerged as a key factor in severe COVID-19 cases – making it a critical therapeutic target. However, its pathophysiology was poorly understood, which hindered effective treatment. SARS-CoV-2 initially disrupts angiotensin signalling, promoting inflammation through ACE-2 downregulation. Some patients’ immune systems then fail to shift from innate to adaptive immunity, suppressing interferon responses and leading to excessive pyroptosis and neutrophil activation. This amplifies tissue damage and inflammation, creating a pro-inflammatory loop. The result is the disruption of Th1/Th2 and Th17/Treg balances, lymphocyte exhaustion, and extensive blood clotting. Cytokine storm treatments include glucocorticoids to suppress the immune system, monoclonal antibodies to neutralize specific cytokines, and JAK inhibitors to block cytokine receptor signalling. However, the most effective treatment options for mitigating SARS-CoV-2 infection remain vaccines as a preventive measure and antiviral drugs for the early stages of infection. This article synthesizes insights into immune dysregulation in COVID-19, offering a framework to better understand cytokine storms and to improve monitoring, biomarker discovery, and treatment strategies for COVID-19 and other conditions involving cytokine storms. COVID-19 severe disease cytokine storm inflammation immune system treatment covid-19 imunski sistem true false true Angleški jezik Slovenski jezik Članek v reviji 2025-03-13 13:45:54 2025-03-13 13:46:01 2025-03-14 03:56:02 0000-00-00 00:00:00 2025 0 0 Str. 1-17 Vol. 82 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 614 1879-0305 10.1016/j.cytogfr.2024.12.003 222549507 1-s2.0-S1359610124001047-main.pdf 1-s2.0-S1359610124001047-main.pdf 1 9BF950A34F7DEBC211A1929E36C0FFEE ec09a50cdf98aa8774a6e2a26a94e7cfccde75d8f1a43cf2a9823e45ceac61f6 8087984f-0008-11f0-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=200632 https://www.sciencedirect.com/science/article/pii/S1359610124001047 0 5918698e-0008-11f0-b232-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=200631 Fakulteta za farmacijo Medicinska fakulteta 0 0 0