Five cytokines increase the risk of “cytokine storms” in COVID-19 patients

The overstimulation of the immune system due to COVID-19 has been found to worsen the condition of patients affected by the disease. Instead of fighting the SARS-CoV-2 coronavirus, an overactive immune response known as a “cytokine storm” can damage healthy cells and increase the damage to the body. However, researchers have developed a new blood test that can help identify patients who are at greatest risk of being exposed to the uncontrolled attack of the immune system.

The study by scientists at the University of Southampton described a blood profile to test five cytokines that can help predict which patients are at risk of fatal immune system overactivity. This can help treat patients individually and reduce the harm.

“These results from the ongoing COVID research program in Southampton have identified key inflammatory signals that will help guide the development of treatment strategies for this new disease,” said Prof. Tom Wilkinson, lead author of the study, in a statement.

Effects of cytokine storms

Cytokines are signaling proteins that regulate the immune system by drawing immune cells to the infection site. However, in patients with severe COVID-19, the immune system’s signaling mechanism is compromised and a turbulent response known as a “cytokine storm” damages healthy cells.

This irregular immune response leads to injury to vital organs such as the lungs and ultimately death. Therefore, identifying people who are at greater risk of developing such a reaction and treating hyperinflammation can serve as an important measure in reducing undesirable outcomes in COVID-19 patients.

The four riders of the Cytokine Storm

For the study, the authors examined the blood samples from 100 patients who tested positive for COVID-19 and were hospitalized between March 20 and April 29, 2020 at the NHS Foundation Trust (UHS) at Southampton University Hospital.

It was found that the elevated levels of four cytokines – IL-6, IL-8, IL-1β, IL-33, and TNF – in the blood of these patients during admission are strongly related to their chances of requiring mechanical ventilation . Critical care and increased chances of death. It has been found that two cytokines, particularly IL-1? and IL-33, have the greatest impact.

The current study is part of a larger study led by lead author Dr. Tristan Clark – the CoV-19POC study. The aim is to understand the clinical impact of molecular point-of-care testing on suspicious COVID-19 patients admitted to UHS. The research also includes tests that drastically cut the time it takes to diagnose coronavirus infection.

Integrating the cytokine test with a proper clinical assessment of the patient’s condition can help doctors identify and treat those who are most at risk of serious consequences. Dr. Clark commented, “Our results suggest that testing for COVID-19 and cytokines at the point-of-care is possible and will, in the future, identify infected patients and the most appropriate treatment for them in near real time.”

Develop new treatments

According to the authors, two treatments are currently expected to be effective for COVID-19 patients in hospital. In patients who require oxygen supplementation, the use of the steroid dexamethasone has been found to reduce death rates by a third.

The underlying mechanism of the protective effect of dexamethasone is unknown. However, it suggests that it may serve as a non-specific anti-inflammatory agent with the potential to regulate the inflammatory response of the immune system.

The research team believes that accurately identifying the cytokines responsible for hyperinflammation in individual patients can enable clinicians to target these cytokines using drugs such as an IL-33 blocker, which has been used in some studies in the UK. treat specifically. This could also help enable personalized treatment – a concept known as “precision medicine”.

“It is becoming more and more obvious that COVID is very heterogeneous. Only by using these techniques to stratify the condition can we target the major disease mechanisms with the best treatment for that person, ”concluded Prof. Wilkinson.