Chloroquine (CQ) and hydroxychloroquine (HCQ) are derivatives of 4-aminoquinoline compounds with over 60 years of safe clinical usage. CQ and HCQ are able to inhibit the production of cytokines such as interleukin- (IL-) 1, IL-2, IL-6, IL-17, and IL-22. Also, CQ and HCQ inhibit the production of interferon- (IFN-) α and IFN-γ and/or tumor necrotizing factor- (TNF-) α. Furthermore, CQ blocks the production of prostaglandins (PGs) in the intact cell by inhibiting substrate accessibility of arachidonic acid necessary for the production of PGs. Moreover, CQ affects the stability between T-helper cell (Th) 1 and Th2 cytokine secretion by augmenting IL-10 production in peripheral blood mononuclear cells (PBMCs). Additionally, CQ is capable of blocking lipopolysaccharide- (LPS-) triggered stimulation of extracellular signal-modulated extracellular signal-regulated kinases 1/2 in human PBMCs. HCQ at clinical levels effectively blocks CpG-triggered class-switched memory B-cells from differentiating into plasmablasts as well as producing IgG. Also, HCQ inhibits cytokine generation from all the B-cell subsets. IgM memory B-cells exhibits the utmost cytokine production. Nevertheless, CQ triggers the production of reactive oxygen species. A rare, but serious, side effect of CQ or HCQ in nondiabetic patients is hypoglycaemia. Thus, in critically ill patients, CQ and HCQ are most likely to deplete all the energy stores of the body leaving the patient very weak and sicker. We advocate that, during clinical usage of CQ and HCQ in critically ill patients, it is very essential to strengthen the CQ or HCQ with glucose infusion. CQ and HCQ are thus potential inhibitors of the COVID-19 cytokine storm.

中文翻译：

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阐明氯喹和羟氯喹的关键免疫调节和抗炎潜力

氯喹（CQ）和羟氯喹（HCQ）是4-氨基喹啉化合物的衍生物，具有60多年的安全临床使用历史。CQ和HCQ能够抑制细胞因子的生成，例如白介素（IL-1），IL-2，IL-6，IL-17和IL-22。此外，CQ和HCQ抑制干扰素-（IFN-）α和IFN- γ和/或肿瘤坏死因子-（TNF-）α的产生。此外，CQ通过抑制生产PG所必需的花生四烯酸的底物可及性来阻止完整细胞中前列腺素（PG）的产生。此外，CQ通过增加外周血单核细胞（PBMC）中的IL-10产量来影响T辅助细胞（Th）1和Th2细胞因子分泌的稳定性。此外，CQ能够阻断脂多糖（LPS）触发的人PBMC中细胞外信号调节的细胞外信号调节激酶1/2的刺激。HCQ在临床水平上可以有效阻止CpG触发的类转换记忆B细胞分化为成浆细胞以及产生IgG。同样，HCQ抑制所有B细胞亚群的细胞因子生成。IgM记忆B细胞表现出最大的细胞因子产生。不过，CQ触发了活性氧的产生。在非糖尿病患者中，CQ或HCQ的罕见但严重的副作用是低血糖症。因此，在重症患者中，CQ和HCQ最有可能消耗掉人体的所有能量存储，使患者非常虚弱和患病。我们主张，在危重病人的临床使用CQ和HCQ期间，通过输注葡萄糖来增强CQ或HCQ非常重要。因此，CQ和HCQ是COVID-19细胞因子风暴的潜在抑制剂。通过输注葡萄糖来增强CQ或HCQ非常重要。因此，CQ和HCQ是COVID-19细胞因子风暴的潜在抑制剂。通过输注葡萄糖来增强CQ或HCQ非常重要。因此，CQ和HCQ是COVID-19细胞因子风暴的潜在抑制剂。