- Epstein-Barr virus has proteins of sequence and functional homology with cytokines of the host. Due to cytokines mediating innate immune response, sustaining /or dysregulating of their actions result in hypercytokinemia which is known as cytokine storm syndrome. Cytokine storm is the symptom of hemophagocytic lymphohistiocytosis caused by Epstein-Barr viral infection where very high levels of cytokines are found in serum such as interferon-gamma which is more than 100 u/ml ( the normal is less than 1.0 u/ml), SCD 25 which is more than 10,000 u/ml ( the normal is less than 2000 u/ml ) as well as a significant rise in levels of IL -6, IL-10 and IL-18.
- My question is, why cytokine storm syndrome which is known to be caused by the Epstein-Barr virus, now, have been correlated or linked to COVID-19?
References:
Cytokine storm and cytokine release syndrome are life-threatening systemic inflammatory syndromes involving elevated levels of circulating cytokines and immune-cell hyperactivation that can be triggered by various therapies, pathogens, cancers, autoimmune conditions, and monogenic disorders. This is a very comprehensive definition taken form a review in the NEJM. I want to remark that Cytokine storm is defined in plural remarking that includes different mechanisms depending on the associated disorder or trigger. Currently everybody relates cytokine storm with Covid19 but cytokine storm is important in many other conditions including sepsis, CAR-T therapy, GVHD, and somehow macrophage activation ( haemophagocytic ) syndromes
I am attached some selected excellent, recent and comprehensive reviews
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