Cytokine storm and targeted therapy in hemophagocytic lymphohistiocytosis

Immunol Res. 2022 Oct;70(5):566-577. doi: 10.1007/s12026-022-09285-w. Epub 2022 Jul 11.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening systemic hyperinflammatory syndrome. The central pathogenesis is an explosive cytokine storm characterized by a significant increase in proinflammatory cytokines, including IL-1β, IL-6, IL-18, IFN-γ, and TNF-α. Meanwhile, negative regulatory factors, such as IL-10 and TGF-β, are also related to the production of HLH. Exploring the specific mechanism of cytokine storms could provide ideas regarding targeted therapy, which could be helpful for early treatment to reduce the mortality of HLH. Although some research has focused on the advantages of targeted therapies, there is still a lack of a comprehensive discourse. This article attempts to summarize the mechanisms of action of various cytokines and provide a therapeutic overview of the current targeted therapies for HLH.

Keywords: Cytokine inhibitor; Cytokine storm; Hemophagocytic lymphohistiocytosis; IFN-γ; Targeted therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cytokine Release Syndrome / drug therapy
  • Cytokines
  • Humans
  • Interleukin-10
  • Interleukin-18
  • Interleukin-6
  • Lymphohistiocytosis, Hemophagocytic* / drug therapy
  • Transforming Growth Factor beta
  • Tumor Necrosis Factor-alpha

Substances

  • Cytokines
  • Interleukin-18
  • Interleukin-6
  • Transforming Growth Factor beta
  • Tumor Necrosis Factor-alpha
  • Interleukin-10