In terms of the new adjunctive therapies that are coming to the fore, the concepts of metabolic resuscitation, decatecholaminisation with betablockers and attenuating the pro-inflammatory
cytokine storm with haemoadsorption are particularly attractive.
The pathogenesis of such acute clinical decline is explained by the massive histamine release and
cytokine storm, and this hypothesis is evident by the temporal relation between the initiation of imatinib therapy and the dramatic decline of eosinophilic count to zero within hours of therapy.
Yang, "The
cytokine storm of severe influenza and development of immunomodulatory therapy," Cellular & Molecular Immunology, vol.
Abrogation of PDH suppression in infected mice by DADA was associated with significant restoration of energy metabolism and suppression of
cytokine storm. Inoculation of a sub-lethal dose of IAV infection resulted in significant increases in the levels of all tested proinflammatory cytokines (IL-1[beta], IL-6, IL-2, TNF-[alpha], IFN-[alpha], IFN-[beta] and IFN-[gamma]) in lung homogenates (between 1.2- and 13.7-fold relative to the baseline, i.e., before infection) (Fig.
A
cytokine storm can result in increased severity of symptoms and, in many instances, to multiple organ failure and death.
Fortunately, most of us never have to face a true
cytokine storm. Instead, we experience the cumulative effects of lower levels of cytokines, maintaining a steady and rising drumbeat of chronic inflammation that destroys our blood vessels, bones, and joints, promotes cancer development, and lays waste to our brain cells to rob us of memory and cognition.
(21,22) Treatment with ARV cessation has led to rebound HIV RNA, which can have implications for the individual, "rebound
cytokine storm," and for society, with increased risk of viral transmission due to the presence of higher levels of HIV in the blood and genital secretions.
If the immune system is unable to defeat the virus before it gains a firm foothold in the epithelial cells of the lungs, white blood cells continue to swarm, creating a "
cytokine storm," which has a toxic effect on the alveoli and capillaries.
Its fatal complications such as pneumonia are attributed to '
cytokine storm', an exaggerated innate immunity response to the virus.
The immune suppressive effect of IVIg may benefit patients by reducing the
cytokine storm. These data suggest use of IVIg, especially preparations containing high neutralizing activity against subtype H5N1, as adjunctive treatment for infection with highly pathogenic avian influenza virus (H5N1).
A new germ may come along that knows how to bypass or disarm the immune system, such as the virus that causes AIDS, for example, or the new kid on the block, the H1N1 "swine flu" influenza virus that causes a "
cytokine storm" that overwhelms our lungs and other organ systems.