&lt;p&gt;Current approaches in the grading and management of cytokine release syndrome after chimeric antigen receptor T-cell therapy&lt;/p&gt;

Riegler, Lara; Jones, Gavin; Lee, Dong Hoon

doi:10.2147/tcrm.s150524

Cited by 118 publications

(118 citation statements)

References 38 publications

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“…CRS occurs when large numbers of leukocytes (neutrophils, macrophages, and mast cells) are activated and release a high concentration of proinflammatory cytokines [79]. CRS was initially described as an adverse effect of monoclonal antibody therapies, and is also common in chimeric antigen receptor (CART) T-cell therapies [80]. The main cytokines involved in CRS pathogenesis include interleukin 6 (IL-6), IL-10, IFN, monocyte chemotactic protein 1 (MCP-1), and GM-CSF; other cytokines such as TNF, IL-1, IL-2, IL-2 receptor, and IL-8 have also been described during CRS.…”

Section: Oxidative Stress and Interaction With The Immune System In Tmentioning

confidence: 99%

Implications of Oxidative Stress and Potential Role of Mitochondrial Dysfunction in COVID-19: Therapeutic Effects of Vitamin D

et al. 2020

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Due to its high degree of contagiousness and like almost no other virus, SARS-CoV-2 has put the health of the world population on alert. COVID-19 can provoke an acute inflammatory process and uncontrolled oxidative stress, which predisposes one to respiratory syndrome, and in the worst case, death. Recent evidence suggests the mechanistic role of mitochondria and vitamin D in the development of COVID-19. Indeed, mitochondrial dynamics contribute to the maintenance of cellular homeostasis, and its uncoupling involves pathological situations. SARS-CoV-2 infection is associated with altered mitochondrial dynamics with consequent oxidative stress, pro-inflammatory state, cytokine production, and cell death. Furthermore, vitamin D deficiency seems to be associated with increased COVID-19 risk. In contrast, vitamin D can normalize mitochondrial dynamics, which would improve oxidative stress, pro-inflammatory state, and cytokine production. Furthermore, vitamin D reduces renin–angiotensin–aldosterone system activation and, consequently, decreases ROS generation and improves the prognosis of SARS-CoV-2 infection. Thus, the purpose of this review is to deepen the knowledge about the role of mitochondria and vitamin D directly involved in the regulation of oxidative stress and the inflammatory state in SARS-CoV-2 infection. As future prospects, evidence suggests enhancing the vitamin D levels of the world population, especially of those individuals with additional risk factors that predispose to the lethal consequences of SARS-CoV-2 infection.

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Section: Oxidative Stress and Interaction With The Immune System In Tmentioning

confidence: 99%

Implications of Oxidative Stress and Potential Role of Mitochondrial Dysfunction in COVID-19: Therapeutic Effects of Vitamin D

et al. 2020

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“…Siltuximab is another monoclonal antibody that blocks IL-6 signaling by binding to IL-6 itself and preventing it from activating immune effector cells [ 45 ]. While it is not examined extensively for use in the context of CRS management, and hence not FDA approved, it has a higher affinity for IL-6 than tocilizumab and can be considered in patients not responding to tocilizumab and corticosteroids.…”

Section: Chimeric Antigen Receptor T Cell Therapymentioning

confidence: 99%

Cardiotoxicity of Contemporary Anticancer Immunotherapy

Dalbo

Patel

Parikh

et al. 2020

Curr Treat Options Cardio Med

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Purpose of review Contemporary anticancer immunotherapy, particularly immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell therapy, has changed the landscape of treatment for patients with a variety of malignancies who historically had a poor prognosis. However, both immune checkpoint inhibitors and CAR T cell therapy are associated with serious cardiovascular adverse effects. As immunotherapy evolves to include high-risk patients with preexisting cardiovascular risk factors and disease, the risk and relevance of its associated cardiotoxicity will be even higher. Recent findings ICI can cause myocarditis, which usually occurs early after initiation, can be fulminant, and prompt treatment with high-dose corticosteroids is crucial. CAR T cell therapy frequently leads to cytokine release syndrome, which is associated with cardiomyopathy or arrhythmia development and may also result in circulatory collapse. Supportive treatment, as well as tocilizumab, an anti-interleukin-6 receptor antibody, is the cornerstone of treatment. Recent findings suggest that preexisting cardiovascular risk factors and disease may increase the risk of such cardiotoxicity, and prompt recognition, as well as treatment, may favorably alter the outcomes. Summary ICI and CAR T cell therapy have improved cancer-related outcomes; however, they both are associated with potentially therapy-limiting cardiotoxicity. Cardio-oncologists are required to play an important role in patient selection, pretherapy cardiovascular optimization, and prompt recognition and treatment of cardiotoxicity.

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“…17, 7.19) greater in patients with complicated compared to non-complicated COVID-19 (52). Tocilizumab 19 (ACTEMRA®) is FDA approved for the treatment of severe cytokine release syndrome in patients treated with CAR T cell therapy and also approved for the treatment of rheumatoid arthritis (53)(54)(55)(56). Tocilizumab is a monoclonal antibody that binds the IL-6 receptor, both the membrane bound and soluble forms, thus inhibiting both classic and trans-IL-6 downstream signaling.…”

Section: Ribavirin Resemble Adenosine or Guanosine Nucleosides That Tmentioning

confidence: 99%

COVID-19 Clinical Trials

Ky¹,

Mann²

2020

JACC: Basic to Translational Science

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The COVID-19 pandemic has resulted in a proliferation of clinical trials that are designed to slow the spread of SARS-CoV-2, the virus that causes COVID-19. The overwhelming majority of cardiovascular and cancer patients are at increased risk for SARS-CoV-2 infection; accordingly, the cardiovascular and cardio-oncology communities are playing a major role in caring for COVID-19 patients. Many of the therapeutic agents that are being used to treat patients with COVID-19 are repurposed treatments for influenza, drugs that were not effective in Ebola patients, or treatments for malaria that were developed decades ago, and are unlikely to be familiar to the cardiovascular and cardio-oncology communities. Here we have provided a foundation for cardiovascular and cardio-oncology physicians who are on the frontline providing care to COVID-19 patients, so that they can better understand the emerging cardiovascular epidemiology of COVID-19, as well as the biological rationale for the clinical trials that are ongoing for the treatment of COVID-19 patients.

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<p>Current approaches in the grading and management of cytokine release syndrome after chimeric antigen receptor T-cell therapy</p>

Cited by 118 publications

References 38 publications

Implications of Oxidative Stress and Potential Role of Mitochondrial Dysfunction in COVID-19: Therapeutic Effects of Vitamin D

Implications of Oxidative Stress and Potential Role of Mitochondrial Dysfunction in COVID-19: Therapeutic Effects of Vitamin D

Cardiotoxicity of Contemporary Anticancer Immunotherapy

COVID-19 Clinical Trials

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