Perspectives on Targeting IL-6 as a Potential Therapeutic Strategy for COVID-19

J Interferon Cytokine Res. 2021 Feb;41(2):37-43. doi: 10.1089/jir.2020.0135.

Abstract

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been a major threat to global public health. In Indonesia, the cases have rapidly increased, and the case fatality rate remains high. With COVID-19, most of the deaths have been caused by acute respiratory distress syndrome and dysregulation of the immune response. A lung biopsy from a patient with COVID-19 showed inflammatory cellular infiltration with diffuse alveolar damage. Massive pulmonary destruction has also been reported as a result of highly increased levels of proinflammatory cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β, interferon-γ (IFN-γ), induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1). IL-6 is an inflammatory cytokine produced by various cell types, including immune cells and nonleukocytes, such as endothelial cells, fibroblasts, epithelial cells, type II pneumocytes, and certain tumor cells. Several studies have shown that IL-6 contributes to the severity and mortality of COVID-19. In this review, we would like to explore the immune response in COVID-19 and the role of IL-6 in the immunopathogenesis of COVID-19.

Keywords: coronavirus disease 2019; immune response; interleukin-6.

Publication types

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

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • COVID-19 / pathology*
  • COVID-19 Drug Treatment
  • Cytokine Release Syndrome / drug therapy
  • Cytokine Release Syndrome / pathology
  • Cytokine Release Syndrome / prevention & control
  • Humans
  • Indonesia
  • Interleukin-6 / immunology
  • Janus Kinase 1 / antagonists & inhibitors
  • Janus Kinase 2 / antagonists & inhibitors
  • Janus Kinase Inhibitors / therapeutic use
  • Nitriles
  • Pyrazoles / therapeutic use
  • Pyrimidines
  • Receptors, Interleukin-6 / antagonists & inhibitors*
  • Respiratory Distress Syndrome / drug therapy*
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / immunology*
  • Signal Transduction / immunology

Substances

  • Antibodies, Monoclonal, Humanized
  • IL6 protein, human
  • Interleukin-6
  • Janus Kinase Inhibitors
  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • Receptors, Interleukin-6
  • ruxolitinib
  • JAK1 protein, human
  • JAK2 protein, human
  • Janus Kinase 1
  • Janus Kinase 2
  • tocilizumab
  • sarilumab