Author/Editor		Jakopin, Žiga; Lunder, Mojca; Anderluh, Marko; Bratkovič, Tomaž
Title		Blaženje sindroma sproščanja citokinov pri covid-19
Translated title		Alleviating cytokine release syndrome in covid-19
Type		članek
Vol. and No.		Letnik 71, št. 2
Publication year		2020
Volume		str. 152-162
ISSN		0014-8229 - Farmacevtski vestnik : strokovno glasilo slovenske farmacije
Language		slv
Abstract		Za hudo obliko koronavirusne bolezni 19 (covid-19) je značilno zajetno sproščanje vnetnih citokinov, imenovano tudi citokinska nevihta. Ker imunski mehanizmi ne uspejo zamejiti namnoževanja virusa SARSCoV-2 v zgodnji fazi okužbe, sta kasnejši velika virusna obremenitev ter obsežna apoptoza endotelijskih celic in pnevmocitov odgovorni za vdor nevtrofilcev in makrofagov v pljučno tkivo. Ti sproščajo citokine, ki na mesto vnetja privabljajo nove imunske celice. Visoka koncentracija vnetnih citokinov izzove povečano prepustnost kapilar in sindrom akutne dihalne stiske zaradi alveolarnega edema ter aktivira koagulacijsko kaskado, kar vodi v dihalno odpoved in odpoved drugih organov. Zaviranje sproščanja vnetnih citokinov ali blokiranje njihove signalizacije tako predstavlja potencialno podporno zdravljenje hude oblike covid-19. V prispevku predstavljamo terapevtske strategije blaženja citokinske nevihte, ki spremlja covid-19. Trenutno kot imunomodulatorje v ta namen v kliničnih raziskavah vrednotijo predvsem zaviralce Janusove kinaze, antagoniste interlevkinov 6 in 1, azitromicin in hidroksiklorokin.Severe coronavirus disease 19 (covid-19) is characterized by a surge of pro-inflammatory cytokines, termed cytokine storm. As the SARS-CoV-2 virus evades early clearance by the immune system, high viral load, and endothelial and pulmonary epithelial cell apoptosis in later stages of infection are responsible for infiltration of lung tissue by neutrophils and macrophages. These, in turn, release cytokines, attracting further immune cells to the site of inflammation. High concentration of cytokines induces leakage of blood vessels, acute respiratory distress due to alveolar edema, activation of coagulation pathways, and consequent irreversible damage to lungs and other organs. Blocking the release or interfering with pro-inflammatory cytokine signalling should thus be considered as supportive therapy for severe covid-19. Here, we review therapeutic strategies aimed at alleviating covid-19-related cytokine storm. Some of the most promising immunomodulatory drugs being evaluated for this indication in on-going clinical trials are Janus kinase inhibitors, interleukin 6 and 1 antagonists, azithromycin and hydroxychloroquine.
Descriptors		Pandemije Citokini
Keywords		pandemija covid-19 SARS-CoV-2 citokinska nevihta imunomodulatorji sindrom sproščanja citokinov