Could Nutraceutical Approaches Possibly Attenuate the Cytokine Storm in COVID-19 Patients?

The critical impacts of cytokine storms in respiratory disorders

“… Pro-inflammatory cytokine Role in cytokine storm Reference IL-6 Causes activation of JAK/STAT signalling pathway which results in hyper-activation of inflammatory cum immune pathways. Causes transformation and maturation of CD8 + T and B cells [[ 57 , 58 ], 202] IFN-γ Activates JAK/STAT pathway and causes proliferation and sensitization of macrophage, NK, and T cell. [ [59] , [60] , [61] ,198] TNFα TNFα acts as activator of NF-κB which causes up-regulation of the inflammatory and apoptotic genes in immune cells [[ [55] , [62] , [63] , [64] , [65] , [66] ], 197] IL-1β NLRP3 inflammasome causes cleavage of IL-1βprecursor to active form of IL-1β which provides positive feedback for NF-κB activation which initiates the inflammatory cascade.…”

“…In patients with lung infections, CS has been found to have hemophagocytic macrophages in their bone marrow. Interferon-γ (IFN-γ) causes macrophage-induced hemophagocytosis, which may contribute to the cytopenia found in CS patients [ [57] , [58] , [59] ]. NK cells cause cytolysis, which is decreased in some types of cytokine storm, resulting in prolonged stimulation of antigenic determinants and ineffective resolution of inflammation [ 60 ].…”

“…Studies that attempted to ameliorate CS by inhibiting IL-1 have received a lot of attention. An IL-1 blocker, Anakinra, resulted in an improvement in the 28-day survival rate of seriously ill COVID-19 individuals with extreme sepsis when treated for infection-induced CS [ 58 ]. There is inadequate data that supports the use of specific IL-1 class antagonists for the treatment of COVID-19, which requires additional verification in actual clinical settings using randomized case-control clinical studies [ 179 ] ( Fig.…”