Alparslan Kadir DEVRİM, Tuba DEVRİM, Elisha Apatewen AKANBONG, Ali ŞENOL

COVID-19'U ANLAMAK: SİTOKİN ETKİSİNİN İMMÜNOPATOJENİK MEKANİZMALARI

Sitokin salınım sendromu (SSS) veya sitokin fırtınası, SARS-CoV-2 tarafından başlatılabilen, bağışıklık sisteminin orantısız tepkisinden kaynaklanan proinflamatuar sitokinlerin aşırı üretiminin bir sonucudur. SARS-CoV-2'nin neden olduğu COVID-19, sitokinlerle korelasyon göstermektedir. SARS-CoV-2, yaygın dağılım gösteren makrofajlar ve mast hücreleri sayesinde IL-1 üretimini tetiklemektedir. IL-1 ise, IL-6 ve TNF-α üretimlerini etkileme eğilimindedir. COVID-19 şiddetinin ilerlemesi, IL-6 gibi bazı sitokin düzeylerini etkiler. IL-6, SSS oluşumundan başlıca sorumlu olan sitokindir. SSS, COVID-19 ile ilgili komplikasyonların ve COVID-19 ile ilişkili ölümlerin ana nedenidir. Bu zamana kadar literatürde bildirilmiş verilere rağmen, SARS-CoV-2 ve sitokinler arasındaki ilişki tam olarak aydınlatılmış değildir. Bu derleme ile söz konusu ilişkinin irdelenmesi amaçlamıştır. COVID-19 tedavisi sırasında sitokinlerin hedeflenmesi, hastaların hayatta kalma oranlarını artırma ve COVID-19 ile ilişkili ölümleri azaltma potansiyelini taşımaktadır. COVID-19 hastalığında, sitokin salınım mekanizmalarına ve salınan sitokinlerin etkilerine odaklanılmasının, özellikle T lenfositler üzerindeki etkilerinin ve IFN-γ üretiminin irdelenmesinin, hastalığın ölümcül etkilerini azaltmaya yardımcı olabileceği düşünülmektedir.

COMPREHENDING COVID-19: IMMUNOPATHOGENIC MECHANISMS OF CYTOKINE ACTION

Cytokine release syndrome (CRS) or cytokine storm is as a result of the excess production of pro-inflammatory cytokines which is due to the disproportionate response of the immune system which can be instigated by SARS-CoV-2. COVID-19 which is caused by SARSCoV- 2 has a correlation with cytokines. SARSCoV- 2 instigates the production of IL-1 by ubiquitous macrophages and mast cells. IL-1 tends to influence the production of IL-6 and TNF-α. The progression of COVID-19 severity influences the level of certain cytokines such as IL-6. IL-6 is the cytokine chiefly responsible for the occurrence of CRS. CRS is the cause of COVID-19-related complications and the main cause of COVID-19-related deaths. Despite the data reported in the literature so far, the relationship between SARS-CoV-2 and cytokines has not been fully elucidated. The aim of the present review is to examine the relationship in question. Targeting cytokines during COVID-19 treatment has the potential to increase patient survival and reduce COVID-19-related deaths. It is concluded that focusing on the mechanisms of cytokine release and the effects of released cytokines, especially examining the effects on T lymphocytes and IFN-γ production in COVID-19 disease, may help reduce the lethal effects of the disease.

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