The immunopathogenesis of a cytokine storm : the key mechanisms underlying severe COVID-19

Hiti, Luka (avtor), Markovič, Tijana (avtor), Lainščak, Mitja (avtor), Farkaš-Lainščak, Jerneja (avtor), Pal, Emil (avtor), Mlinarič-Raščan, Irena (avtor)

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.

• Jezik: Angleški jezik
• Ključne besede: COVID-19, severe disease, cytokine storm, inflammation, immune system, treatment
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.02 - Pregledni znanstveni članek
• Organizacija: FFA - Fakulteta za farmacijo ; MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2025
• Št. strani: Str. 1-17
• Številčenje: Vol. 82
• PID: 20.500.12556/RUL-167824
• UDK: 614
• ISSN pri članku: 1879-0305
• DOI: 10.1016/j.cytogfr.2024.12.003
• COBISS.SI-ID: 222549507
• Datum objave v RUL: 13.03.2025

Gradivo je del revije

• Naslov: Cytokine & growth factor reviews
• Skrajšan naslov: Cytokine growth factor rev.
• Založnik: Elsevier
• ISSN: 1879-0305
• COBISS.SI-ID: 175319555

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: covid-19, imunski sistem