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Curr Med Chem . The role of Interleukin-6 in the pathogenesis, prognosis and treatment of severe COVID-19

tetano

Editor, Senior Moderator
Curr Med Chem


. 2020 Dec 8.
doi: 10.2174/0929867328666201209100259. Online ahead of print.
The role of Interleukin-6 in the pathogenesis, prognosis and treatment of severe COVID-19


Ilias Giannakodimos[SUP] 1 [/SUP], Georgia-Vasiliki Gkountana[SUP] 2 [/SUP], Dimosthenis Lykouras[SUP] 1 [/SUP], Kiriakos Karkoulias[SUP] 1 [/SUP], Sotiris Tsakas[SUP] 2 [/SUP]



Affiliations

Abstract

A newly identified virus appeared in Wuhan, China, in December 2019, was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and causes the coronavirus disease 2019 (COVID-19). SARS-CoV-2 presents similarities with two previous coronavirus pandemics, MERS (Middle East Respiratory Syndrome) and SARS-CoV, concerning phylogenetic origin, structural composition, and clinical symptoms, thus, leading to common pathogenic mechanisms. The purpose of this review is to declare the role of interleukin-6 (IL-6) in the pathogenesis, prognosis, and treatment of COVID-19 by comparing its effect on SARS-CoV and MERS cases. Increased levels of IL-6 comprise the key for the stimulation of cytokine storm and the progression of SARS, MERS, and COVID-19 cases. Especially, in COVID-19 patients, the overactivation of NF-kΒ, which is caused by the binding of coronavirus spike protein S to alveolar epithelial cells, up-regulates IL-6 and promotes its systematic circulation, causing alveolar damage and extrapulmonary injury. Additionally, IL-6 can be used to evaluate respiratory failure and identify asymptomatic patients. Tocilizumab (TCZ), a monoclonal antibody which blocks IL-6 signaling, comprises a remedial option against COVID-19. TCZ improves oxygenation, reduces fever, and decreases levels of IL-6. IL-6 plays a major role in the pathogenesis of cytokine storm and the progression of COVID-19 and may be used as a therapeutic target against COVID-19. However, further research is needed concerning the relation of IL-6 in COVID-19 cases and more clinical trials are required to declare TCZ as a treatment option.

Keywords: COVID-19; Coronavirus; Interleukin-6; Pandemic; SARS-CoV-2; Tocilizumab.
 
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