Abstract
The COVID-19 pandemic has caused a global health crisis, with no specific antiviral to treat the infection and the absence of a suitable vaccine to prevent it. While some individuals contracting the SARS-CoV-2 infection exhibit a well coordinated immune response and recover, others display a dysfunctional immune response leading to serious complications including ARDS, sepsis, MOF; associated with morbidity and mortality. Studies revealed that in patients with a dysfunctional immune response, there is a massive cytokine and chemokine release, referred to as the ‘cytokine storm’. As a result, such patients exhibit higher levels of pro-inflammatory/modulatory cytokines and chemokines like TNFα, INFγ, IL-1β, IL-2, IL-4, IL-6, IL-7, IL-9, IL-10, IL-12, IL-13, IL-17, G-CSF, GM-CSF, MCSF, HGF and chemokines CXCL8, MCP1, IP10, MIP1α and MIP1β. Targeting this cytokine storm is a novel, promising treatment strategy to alleviate this excess influx of cytokines observed at the site of infection and their subsequent disastrous consequences. Natural immunosuppressant compounds, derived from plant sources like curcumin, luteolin, piperine, resveratrol are known to inhibit the production and release of pro-inflammatory cytokines and chemokines. This inhibitory effect is mediated by altering signal pathways like NF-κB, JAK/STAT, MAPK/ERK that are involved in the production and release of cytokines and chemokines. The use of these natural immunosuppressants as adjuvants to ameliorate the cytokine storm; in combination with antiviral agents and other treatment drugs currently in use presents a novel, synergistic approach for the treatment and effective cure of COVID-19. This review briefly describes the immunopathogenesis of the cytokine storm observed in SARS-CoV-2 infection and details some natural immunosuppressants that can be used as adjuvants in treating COVID-19 disease.
Highlights
The coronavirus disease 2019 (COVID-19) caused by a novel ß-coronavirus, SARS-CoV-2 was first reported in Wuhan, China in December 2019 (Wang et al, 2020a)
This paper discusses the cytokine storm syndrome observed in COVID-19 patients in brief and emphasizes on some natural immunosuppressant agents derived from plants sources that can play an important role in targeting and mitigation of the cytokine storm observed in COVID-19
This study aimed to evaluate the efficacy of nano-curcumin in modulating the levels of inflammatory cytokines IL-1β, IL-6, TNFα and IL-18 in 40 patients
Summary
The coronavirus disease 2019 (COVID-19) caused by a novel ß-coronavirus, SARS-CoV-2 was first reported in Wuhan, China in December 2019 (Wang et al, 2020a). Studies and clinical trials are being conducted to evaluate the efficacy of ruxolitinib to target the excess production of cytokines in COVID-19 patients with hyperinflammation and ARDS (La Rosée et al, 2020; National Institutes of Health, 2020g; National Institutes of Health, 2020h) Baricitinib is another inhibitor that binds to JAK 1/2 and inhibits its activation and consequent cytokine release (National Institutes of Health, 2020i). Targeting the cytokine storm with plant-derived immunosuppressants is a very promising strategic treatment method This is because the individual mediators of the inflammatory cascade; cytokines including IL-1β, IL-6, TNFα and chemokines IP10, MCP1 are neutralized or inhibited, rather than a broad immune suppression that can negatively effect the viral clearance.
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