| What is a Cytokine Storm?
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| | infection (designated a type A, subtype
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| by Steven P. Petrosino, Ph.D. and Angela
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| | "H1N1" virus) may have been the cause of
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| L. Petrosino, MPH
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| | high lethality seen in the influenza
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| A cytokine storm, also called "systemic
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| | pandemic of 1918 to 1919. The great
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| inflammatory response syndrome" (SIRS) is
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| | influenza pandemic was the most
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| the systemic expression of a healthy and
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| | destructive pandemic in recorded world
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| vigorous immune system resulting in the
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| | history, and killed more people
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| release of more than 150 inflammatory
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| | (estimated between 20 to 50 million) than
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| mediators (cytokines, oxygen free
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| | all casualties resulting from the first
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| radicals, and coagulation factors). Both
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| | World War. Although the Spanish Flu
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| pro-inflammatory cytokines (such as Tumor
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| | pandemic affected an enormous percentage
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| Necrosis Factor-alpha, InterLeukin-1, and
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| | of the world wide population (up to 20%
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| InterLeukin-6) and anti-inflammatory
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| | of the world population according to some
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| cytokines (such as interleukin 10, and
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| | sources), and killed between 20 and 50
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| interleukin 1 receptor antagonist) are
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| | million persons, no more than 5% of the
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| elevated in the serum, and the fierce and
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| | people who contracted the Spanish Flu
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| often lethal interplay of these cytokines
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| | died (Brown et. al reported the highest
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| is referred to as a "Cytokine Storm". The
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| | death rate in India at 50 deaths per 1000
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| primary contributors to the cytokine
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| | persons contracting the disease, or a
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| storm are TNF-a (Tumor Necrosis
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| | five percent fatality rate). After 218
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| Factor-alpha) and IL-6 (Interleukin-6).
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| | human cases of avian influenza (bird flu)
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| The cytokine storm is an inappropriate
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| | have been confirmed world-wide (as of
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| (greatly exaggerated) immune response
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| | May, 2006), the lethality rate stands at
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| that is caused by rapidly proliferating
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| | 57%. Should this strain develop into a
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| and highly activated T-cells or natural
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| | pandemic, and should it keep its current
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| killer (NK) cells. These cells are
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| | mortality rate, it has the potential to
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| themselves activated by infected
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| | be 10 times more lethal than the 1918
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| macrophages. The cytokine storm must be
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| | pandemic.Is the World Health Organization
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| treated and suppressed or lethality can
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| | Adequately Defending against a Potential
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| result.
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| | Pandemic of Avian Influenza
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| | Avian Influenza (also called the "Bird
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| Acute respiratory viral infection
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| | flu") currently is 10 times more lethal
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| results in a cytokine storm effecting the
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| | than the strain of Spanish Flu that
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| lungs, and subsequent damage to alveoli
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| | caused the great influenza pandemic of
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| and lung tissue results in the lethality
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| | 1918 and killed up to 50 million people
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| seen in more severe flu viral infections,
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| | world-wide, and it could become the most
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| especially those fatalities among young
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| | lethal flu pandemic of all history if the
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| healthy adults.
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| | virus mutates allowing it to be more
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|
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| | easily passed from person to person.
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| In the absence of prompt medical
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| | Bird Flu patients die from acute
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| intervention to stop the "cytokine
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| | respiratory distress syndrome (ARDS)
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| storm", the lung will suffer permanent
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| | caused by the "cytokine storm", and NOT
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| damage. Many of these patients will
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| | directly from the virus. Neuraminidase
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| develop acute respiratory distress
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| | inhibitors (i.e. Tamiflu, Relenza) are
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| syndrome (ARDS), i.e. will present with
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| | not proven effective for bird flu
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| pulmonary edema that is not caused by
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| | patients, although they have been
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| volume overload, or a depressed left
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| | recommended by the World Health
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| ventricular function. Deaths will usually
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| | Organization for this use, are currently
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| result from multisystem organ failure,
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| | used to treat almost all bird flu
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| and not from lung failure.
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| | patients, and are being stockpiled by
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| Sepsis, Viral Infections, and Cytokine
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| | governments world-wide (including the
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| StormSepsis is a severe systemic
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| | United States) to treat a potential
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| inflammatory response and is one example
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| | pandemic should the avian influenza virus
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| of a pathologic condition associated with
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| | undergo a final mutation which would
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| "cytokine storm". Sepsis is an often
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| | allow it to be more easily passed from
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| lethal hemodynamic collapse which is
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| | person to person. A treatment to prevent
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| usually the result of a super infection
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| | or reduce the autoimmune reaction
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| by gram-negative bacterial endotoxins.
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| | (cytokine storm) associated with the bird
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| Sepsis is also classified as septic shock
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| | flu is commercially available by
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| syndrome (SSS).Cytokine storm can also
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| | prescription, but is not currently being
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| result from viral infections such as
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| | recommended by the World Health
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| influenza, and an exaggerated systemic
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| | Organization to treat these patients.
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| immune response to that particular viral
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