Immunotherapeutic implications of IL-6 blockade for cytokine storm

Immunotherapy. 2016 Jul;8(8):959-70. doi: 10.2217/imt-2016-0020.

Abstract

IL-6 contributes to host defense against infections and tissue injuries. However, exaggerated, excessive synthesis of IL-6 while fighting environmental stress leads to an acute severe systemic inflammatory response known as 'cytokine storm', since high levels of IL-6 can activate the coagulation pathway and vascular endothelial cells but inhibit myocardial function. Remarkable beneficial effects of IL-6 blockade therapy using a humanized anti-IL-6 receptor antibody, tocilizumab were recently observed in patients with cytokine release syndrome complicated by T-cell engaged therapy. In this review we propose the possibility that IL-6 blockade may constitute a novel therapeutic strategy for other types of cytokine storm, such as the systemic inflammatory response syndrome including sepsis, macrophage activation syndrome and hemophagocytic lymphohistiocytosis.

Keywords: IL-6; cytokine storm; interleukin-6; sepsis; tocilizumab.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Blood Coagulation
  • Endothelium, Vascular / pathology
  • Humans
  • Immunotherapy / methods*
  • Inflammation
  • Interleukin-6 / immunology*
  • Lymphohistiocytosis, Hemophagocytic / immunology
  • Lymphohistiocytosis, Hemophagocytic / therapy*
  • Macrophage Activation Syndrome / immunology
  • Macrophage Activation Syndrome / therapy*
  • Sepsis / immunology
  • Sepsis / therapy*

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Interleukin-6
  • tocilizumab