Review: Cytokine Storm Syndrome: Looking Toward the Precision Medicine Era

  title={Review: Cytokine Storm Syndrome: Looking Toward the Precision Medicine Era},
  author={Edward M. Behrens and Gary A. Koretzky},
  journal={Arthritis \& Rheumatology},
“Cytokine storm syndrome” is a diverse set of conditions unified by a clinical phenotype of systemic inflammation, multi-organ failure, hyperferritinemia, and, if untreated, often death. This clinical constellation is caused by the elaboration of extreme amounts of inflammatory mediators resulting from unchecked feedforward immune activation and amplification. The initiating factors leading to the end state of cytokine storm are heterogeneous and derive from rheumatologic, oncologic, and… 
Recent advances in antiviral effects of probiotics: potential mechanism study in prevention and treatment of SARS-CoV-2
This study reviewed recent studies that speculate about the role of probiotics in the prevention of the SARS-CoV-2-induced cytokine storm through the mechanisms such as induction of anti-inflammatory cytokines, downregulation of pro-inflammatoryocytes, inhibition of JAK signaling pathway, and act as HDAC inhibitor.
The role of IL-6 and other mediators in the cytokine storm associated with SARS-CoV-2 infection
A Case of Delayed COVID-19-Related Macrophage Activation Syndrome
A COVID-19 pneumonia patient who was discharged home following improvement in his respiratory symptoms to present few days later with a fatal form of CSS, presenting with ARDS, fulminant hepatic failure and coagulopathy is described.
Cytokine Release Syndrome Following Blinatumomab Therapy
This case report presents a case of cytokine release syndrome following blinatumomab therapy despite premedication with dexamethasone, which represents a supraphysiologic response resulting in excessive release of cytokines and a wide range of systemic manifestations.
Macrophage Polarity and Disease Control
The current state of knowledge on macrophage polarity is assessed and its prospects as a therapeutic target are reported on.
Coronavi rus Disease 2019 ( COVID-19 ) in Ch i ldren : Lessons f rom Pediat r ic Rheumato logy
The article presents the most essential epidemiological, clinical and laboratory characteristics of the syndrome, as well as discusses MIS-C pathogenesis and differential diagnosis aspects with a number of other acute conditions associated with imbalance of cytokines, and available pharmaco-therapies.
A “Window of Therapeutic Opportunity” for Anti-Cytokine Therapy in Patients With Coronavirus Disease 2019
Only considering a more specific set of criteria able to integrate information on direct viral damage, the cytokine burden, and the patient’s immune vulnerability will be possible to decide, carefully balancing both benefits and risks, the appropriateness of using immunosuppressive drugs even in patients affected primarily by an infectious disease.
Pyroptotic Patterns in Blood Leukocytes Predict Disease Severity and Outcome in COVID-19 Patients
To improve the clinical treatment of COVID-19 patients, the least absolute shrinkage and selection operator (LASSO) regression is used to construct a prognostic model based on differentially expressed genes between PYRclusters (PYRsafescore), which can be applied as an effective prognosis tool.
A Landscape Study on COVID-19 Immunity at the Single-Cell Level
An immune outlook for CO VID-19 at the single-cell level is provided and different pathways in immune response of COVID-19 single cells are revealed.


Successful control of juvenile dermatomyositis-associated macrophage activation syndrome and interstitial pneumonia: distinct kinetics of interleukin-6 and -18 levels
Serum IL-6 and IL-18 levels may be useful for predicting the disease activity of JDM-MAS and IP, respectively.
Chimeric antigen receptor-modified T cells for acute lymphoid leukemia.
The emergence of tumor cells that no longer express the target indicates a need to target other molecules in addition to CD19 in some patients with ALL.
Macrophage activation syndrome in children with systemic lupus erythematosus and children with juvenile idiopathic arthritis.
Organ system dysfunction is common inChildren with rheumatic diseases complicated by MAS, and more organ system support is required in children with underlying SLE than in childrenwith juvenile idiopathic arthritis.
A Novel Targeted Approach to the Treatment of Hemophagocytic Lymphohistiocytosis (HLH) with an Anti-Interferon Gamma (IFNγ) Monoclonal Antibody (mAb), NI-0501: First Results from a Pilot Phase 2 Study in Children with Primary HLH
NI-0501 is a fully human, high affinity, anti-IFNγ mAb that binds to and neutralizes human IFNγ, offering a novel and targeted approach for the control of HLH.
Recombinant Human Interleukin 1 Receptor Antagonist in the Treatment of Patients With Sepsis Syndrome: Results From a Randomized, Double-blind, Placebo-Controlled Trial
Primary and retrospective analyses of efficacy suggest that treatment with rhIL-1ra results in a dose-related increase in survival time among patients with sepsis who have organ dysfunction and/or a predicted risk of mortality of 24% or greater.
Inhibition of natural killer (nk) cell cytotoxicity by interleukin-6: implications for the pathogenesis of macrophage activation syndrome
Systemic juvenile idiopathic arthritis (s-JIA) is characterized by high levels of Interleukin-6 (IL-6), and impairment of natural killer cell function and decrease perforin expression have also been reported in sJIA.
Worsening of macrophage activation syndrome in a patient with adult onset Still's disease after initiation of etanercept therapy.
  • A. Stern, R. Riley, L. Buckley
  • Medicine
    Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
  • 2001
The case of a young woman with adult-onset Still's disease (AOSD), complicated by an Epstein-Barr virus infection and subsequent MAS, whose course worsened after administration of the soluble tumor necrosis factor-alpha receptor, etanercept is reported.
Efficacy and safety of monoclonal antibody to human tumor necrosis factor alpha in patients with sepsis syndrome. A randomized, controlled, double-blind, multicenter clinical trial. TNF-alpha MAb Sepsis Study Group.
There was no decrease in mortality between placebo and TNF-alpha MAb in all infused patients, and in septic shock patients who received TNF, a significant reduction in mortality was present 3 days after infusion.