Normally the immune system will go on the attack against a foreign invader such as a germ and then return to standby mode. But according to a report in a recent edition of the New England Journal of Medicine, in some cases the molecular cells are out of control and begin to attack healthy tissues.
For example, instead of protecting the lungs, the immune cells flood the lungs. Blood clots form, organs begin to fail, blood vessels leak, and blood pressure falls. Hence the name cytokine storm. (Cytokines are small proteins that play a role in cell signaling.)
Immune Related Disorders
Many conditions have been identified relating to ‘cytokine storms’ such as autoimmune disorders, infection or faulty genes where the body misreads it own tissues as invaders.
Treatments have been developed that have been somewhat successful in controlling this severe immune system response.
But in the case of COVID-19, researchers find that it is much too early to make a determination for the best course of action to control COVID-19 related cytokine storms.
What Scientists Have Learned About Cytokine Storms
It is established that autoimmune diseases are a group of disorders where impaired immune responses may lead to tissue damage.
However, there is minimal data about COVID-19 patients with impaired immune responses who have been treated with immunomodulatory therapies for any reasonable length of time.
Studies are ongoing to test the efficacy of treatments such as interleukin-6 inhibitors (anticytokine therapies) and hydroxychloroquine (antirheumatic therapies). This protocol is based on the theory that the cytokine storm is responsible for patients needing ventilators or it may also be one of the causes of death from the disease.
Despite the enormous and shocking number of cases and deaths caused by COVID-19, the disease is still relatively new. Therefore, doctors are only now learning of therapies that may be effective against cytokine storms. Without the aid of diagnostic tests for the new virus, doctors must be aware of several symptoms. They may look for elevated levels of the ferritin protein or elevated levels of C-reactive protein that is produced by the liver as a response to inflammation.
Clinicians are searching for improved guidance towards the implications of COVID-19 in patients with immune inflammatory diseases such as rheumatoid arthritis, psoriasis, inflammatory bowel disease, psoriatic arthritis, and other conditions related to these diseases.
The clinicians emphasize that there is an urgent need for more information about the effects of anticytokine biologics and immunosuppressive therapies in COVID-19 patients.