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A combinational approach to restore cytokine balance and to inhibit virus growth may promote patient recovery in severe COVID-19 cases

journal contribution
posted on 25.08.2020, 00:00 authored by A Mahmud-Al-Rafat, M Muzammal Haque Asim, Andrew Taylor-Robinson, A Majumder, A Muktadir, H Muktadir, M Karim, I Khan, M Mainul Ahasan, M Morsaline Billah
The COVID-19 pandemic has led to twin public health and economic crises around the world. Not only has it cost hundreds of thousands of lives but also severely impacted livelihoods and placed enormous strain on community healthcare and welfare services. In this review, we explore the events associated with SARS-CoV-2 pathogenesis and host immunopathological reactivity due to the clinical manifestations of this coronavirus infection. We discuss that the metallopeptidase enzyme ADAM17, also known as tumor necrosis factor-α-converting enzyme, TACE, is responsible for shedding of angiotensin-converting enzyme 2 and membrane-bound interleukin (IL)-6 receptor. This leads to elevated pro-inflammatory responses that result in cytokine storm syndrome. We argue that cytokine balance may be restored by recovering an IL-6 trans-signaling neutralizing buffer system through the mediation of recombinant soluble glycoprotein 130 and recombinant ADAM17/TACE prodomain inhibitor. This cytokine restoration, possibly combined with inhibition of SARS-CoV-2 entry as well as replication and coagulopathy, could be introduced as a novel approach to treat patients with severe COVID-19. In cases of co-morbidity, therapies related to the management of associated disease conditions could ameliorate those clinical manifestations.

History

Volume

136

Start Page

1

End Page

8

Number of Pages

8

eISSN

1096-0023

ISSN

1043-4666

Publisher

Elsevier

Language

en

Peer Reviewed

Yes

Open Access

No

Acceptance Date

31/07/2020

External Author Affiliations

Incepta Vaccine Ltd., Dhaka, Bangladesh; University of Illinois at Chicago, USA; Khulna University, Khulna, Bangladesh

Era Eligible

Yes

Journal

Cytokine