ABSTRACT

Introduction

The globally rampant SARS CoV-2 pandemic requires novel medical strategies to control the severity of disease and death due to complications. Of the 15–20% patients that develop pulmonary symptoms, a sub-set develops an acute respiratory distress syndrome (ARDS) rapidly progressing into a critical condition. Marked elevation of cytokines/chemokines is observed with elevation of additional markers of inflammation, coagulation, and organ damage such as CRP, D-dimer, LDH, Ferritin and Troponin-I. This hyperinflammation leads to worsening of oxygen saturation due to pulmonary infiltration and exudation, organ damage, and dysfunction of coagulation pathway and may lead to multi-organ failure.

Areas Covered

The role of anti-inflammatory monoclonal antibodies such as Itolizumab, in cytokine storm.

Expert Opinion

Itolizumab, an anti-CD6 humanized IgG1 mAb, binds to domain-1 of CD-6 that is responsible for priming, activation, and differentiation of T-cells. Itolizumab significantly reduces T-cell proliferation along with substantial downregulation of the production of cytokines/chemokines. Approved for moderate to severe chronic plaque psoriasis in 2013 it is currently being studied for addressing COVID-19 related cytokine storm and its complications. This article reviews its use in COVID-19 infections; its dose, administration protocol, contra-indications, and safety in treating moderate-to-severe ARDS by preventing and treating the cytokine storm and its complications.

中文翻译：

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抗CD6单克隆抗体Itolizumab，可作为COVID-19并发症的潜在治疗方法。

摘要

介绍

全球猖SA的SARS CoV-2大流行需要新颖的医学策略来控制由于并发症引起的疾病和死亡的严重性。在15–20％的出现肺部症状的患者中，有一个子集会发展为急性呼吸窘迫综合征（ARDS），并迅速发展为危急状况。观察到细胞因子/趋化因子的显着升高，同时炎症，凝血和器官损害的其他标志（例如CRP，D-二聚体，LDH，铁蛋白和肌钙蛋白-I）升高。这种过度炎症会由于肺部浸润和渗出，器官损伤和凝血途径功能障碍而导致血氧饱和度恶化，并可能导致多器官衰竭。

覆盖区域

抗炎性单克隆抗体（例如Itolizumab）在细胞因子风暴中的作用。

专家意见

Itolizumab是一种抗CD6人源化IgG1 mAb，与CD-6的结构域1结合，后者负责引发，激活和分化T细胞。依妥珠单抗可显着降低T细胞增殖，并显着下调细胞因子/趋化因子的产生。2013年批准用于中度至重度慢性斑块状牛皮癣，目前正在研究以解决与COVID-19相关的细胞因子风暴及其并发症。本文回顾了其在COVID-19感染中的用途；通过预防和治疗细胞因子风暴及其并发症来治疗中重度ARDS的剂量，给药方案，禁忌症和安全性。