Talk:Cytokine storm

SIRS

Irwin and Rippe's Intensive Care Medicine doesn't describe this as SIRS. Can anyone validate the claim this is correct? And if this turns out to be true, shouldn't the articles be merged? Nomen Nescio^{Gnothi seauton} 19:19, 29 May 2006 (UTC)

It is not the same, to quote the NEJM:

"Proposed Mechanism of the Cytokine Storm Evoked by Influenzavirus. The key element in generating the storm is an uncontrolled exuberant immune response to the virus, in which there is an outpouring of proinflammatory cytokines and chemoattractants."[1]

Since SIRS by definition is a condition in which infection is absent, this proves SIRS and cytokine storm are NOT the same. In other words, the storm may be part of SIRS, but is not limited to SIRS. Nomen Nescio^{Gnothi seauton} 19:43, 29 May 2006 (UTC)

Cecil's Textbook of medicine (21st edition, year: 2000, Goldman and Bennett, eds.) does not list any reference to "cytokine storm". The first reference in Pub Med appears to be by Ferrara in GVHD, and was published in Feb 1993.

I agree that Cytokine storm and SIRS are indeed not synomous, and that the 2 should be kept as separate topics. Cytokine Storm is not a disease, but a feature of many diseases, both infectious (SEPSIS, avian flu) and non-infectious (i.e. GVHD and SIRS) 23:50, May 30, 2006, User:Petrosino.

Cytokines & Cells Online Pathfinder Encyclopaedia

Although a very interesting site, this is not a medical reference. Please provide a medical journal or textbook. Second, you fail to understand that severe infection also causes a "cytokine storm." Since SIRS is defined as absence of infection how do you differentiate between infection and non-infection related "cytokine storm?" Analogy: apples are fruit, but fruit not necesseraly refers to apples. In short, the assertion is incorrect. Please amend accordingly. Nomen Nescio^{Gnothi seauton} 09:36, 30 May 2006 (UTC)

Like the current version. Explains the concept very good. Thank you. Nomen Nescio^{Gnothi seauton} 06:56, 31 May 2006 (UTC)

Cytokines and H5N1

BBC story on cytokine role in making H5N1 in humans deadly.— Preceding unsigned comment added by 205.175.225.22 (talk) 21:35, 11 September 2006 (UTC)

Just wanted to point out that the cytokine storm concept is not entirely recognized within the field yet... There are some studies done on transgenic mice deficient in various cytokines showing that they have the same mortality as regular mice with H5N1... so cytokine storm is not the whole picture. 70.184.145.25 (talk) 08:44, 3 November 2009 (UTC)

Question

Would selective anti-T-cell medications be useful in the treatment of cytokine storm (ex : tacrolimus ?) ?— Preceding unsigned comment added by 129.78.64.100 (talk) 08:37, 20 February 2007 (UTC) (Retrieved from Talk:Cytokine_storm/Comments)

Can the feline FIP virus be used as an example?

Feline Infectious Peritonitis, formerly a rare disease in cats, is now found in about 1 of 20 purebred cats in 'average' American and European 'catteries'. Though still little understood, veterinarians claim death is rapid in healthy cats if infection is sufficient to trigger a response from the humeral immune system. If this is an example of a cytokine storm, it is, sadly, being experienced by more and more people who have feline family members. It may be useful as an example many people have seen first hand. Geologist (talk) 04:29, 25 May 2008 (UTC)

Dialysis / blood purification

I understood that there were some great successes fighting cytokine storms by utilizing a new type of dialysis. I read about these a couple of years back. Currently, I can't find the citations however. Has this therapy dropped out of vogue? It seemed to hold a lot of promise, if only for individual patients as opposed to epidemiological uses. —Preceding unsigned comment added by 206.109.195.126 (talk) 06:05, 10 November 2008 (UTC)

Sounds more like plasmapheresis. That said, I can't find a reference for that treatment ever being attempted, hence, effectiveness is unknown.Wzrd1 (talk) 19:18, 3 February 2012 (UTC)

This appears to be a press release of some kind from July 2017:

"blood purification" - https://www.americanlaboratory.com/914-Application-Notes/340464-An-Effective-Treatment-Strategy-for-Cytokine-Storm-in-Severe-Influenza/

It sounds like it's being manufactured in the US, but only being tried in Europe(?) If this is actually being tried, then shouldn't there at least be some kind of entry for this approach in the 'Treatments' section? DKEdwards (talk) 19:40, 4 February 2018 (UTC)

Cytokine storms and Cimetidine (Tagamet), Curcumin

I think it is probably worth noting that at least one study (http://www.ncbi.nlm.nih.gov/pubmed/3112984) suggests that (at least in pigs) three commonly available OTC drugs can significantly reduce the most fatal effect of cytokine storms (ARDS) when used in combination. Specifically, the drugs in question were Benadryl (an H1 blocker), Tagamet/cimetidine (an H2 blocker), and Ibuprofen (an antiinflammatory drug). The funny part of that is that most people have at least two and possibly all three of the medications in question in their homes.

It might also be worth noting that some studies suggest Curcumin blocks TNF, so if TNF-alpha inhibitors prove effective, there is at least some possibility of a low-side-effect (mostly heartburn) treatment....

Dgatwood (talk) 05:20, 27 April 2009 (UTC)

Endotoxic shock

Is there a difference between a "cytokine storm" and "endotoxic shock"? --GentlemanGhost (talk) 23:17, 27 April 2009 (UTC)

Yes, there is a significant difference. In endotoxic shock, there is no cytokine storm, only high levels of SOME cytokines.Wzrd1 (talk) 19:20, 3 February 2012 (UTC)

Nothing Said about Antihistamine Effects

This is one thing I have noticed about the drug industry: when dealing with an immune related disease they usually ignore the question of how anti-histamines affect the disease process. For example when antihistamines became available without a prescription the box labeling warned the product was not to be used by asthmatics, yet in the 1990's the FDA determined that that warning had no basis in fact. Ribazole (talk) 14:50, 28 April 2009 (UTC)

The question everyone is wondering

Do alcohol and sugar help against cytokine storm by reducing the immune system? 193.190.253.144 (talk) 09:05, 1 May 2009 (UTC)

No: it's far too little, far too late in the game. You need serious immunosuppressant pharmaceutical agents. WhatamIdoing (talk) 00:05, 5 May 2009 (UTC)

I think the habitual use of immunosuppressants is not helpful. I have seen research suggesting that D3 deficiency causes it the cytokine storm and as most patients are deficient it might be a good idea to treat with massive D3 dose. There seems to be an attitude of best to close down the body's defences and let the doctors do the job. Even vaccines need a n immune system, they don't kill the virus on therir own, which some appear to think. Many studies round the world have shown the importance of D3 to immunity, and the 'coincidence' of all the deaths are of patients with deficient immune systems. Real scientists of course dismiss ;'supplements' as useless, which is why the UK government emeritus advisors refuse to consider it. PetePassword (talk) 12:24, 24 January 2021 (UTC)

Swine Flu

Does the new swine flu virus kill by causing a cytokine storm? http://www.sciencedaily.com/releases/2009/05/090505174547.htm rumjal 05:25, 6 May 2009 (UTC). —Preceding unsigned comment added by Rumjal (talk • contribs)

Probably not, since the fatality rate seems to be quite low. However, this virus is still being studied so we know very little about it at present. Tim Vickers (talk) 16:08, 6 May 2009 (UTC)

Does the fatality rate being low contradict the hypothesis that those who do die experience a cytokine storm? As far as I can see, both the age spectrum of the fatal cases as well as the ARDS most of them experienced and the viral pneumonia do point to a cytokine storm being implicated in at least some of the cases. And have a look at this about the 21-year old Utah man who died:

He went in [to the hospital] Friday night. He was sick, coughing up blood. They said he was just fine. They sent him home. He went back in on Saturday because he was coughing up even more blood," Marcos' sister Deseree Nielson said.

Coughing or vomiting blood was often described in soldiers who died of the Spanish flu (at approximatly the same age as this young man, who his family say was healthy except for sleep apnea, although officials say he suffered from "several underlying medical conditions").By the way, the fatality rate of the Spanish flu was around 2.5% in the fall outbreak. Although this is higher than what we currently see with swine flu, one could also describe the Spanish flu's fatality rate as "low" (considering that 97.5% recovered).Geometer9420 (talk) 08:01, 21 May 2009 (UTC)

Yesterday's news indicates that the severe cases of Pandemic H1N1/09 are distinguished by high levels of Interleukin 17, suggesting T helper 17 as a theraputic target. WP:MEDRS still needed.[2] [3] LeadSongDog come howl 17:39, 16 December 2009 (UTC)

Stories here and here cite Kelvin DJ et al., "Th1 and Th17 hypercytokinemia as early host response signature in severe pandemic influenza" Journal of Critical Care (December 2009). Does someone have access? LeadSongDog come howl 19:28, 16 December 2009 (UTC)

This link should work for everybody. Tim Vickers (talk) 20:47, 16 December 2009 (UTC)

What this paper describes is a correlation between a particular cytokine profile and severe disease. However, since correlation does not prove causation, it doesn't show that these cytokines cause disease, but that they may just the a consequence of high levels of virus replication and tissue damage. After all, infection induces cytokines. As the authors state in their discussion:

High levels of Th-1 and Th-17 related mediators could support the hypothesis of a Th-1+Th- 17 inflammatory response in the origin of the severe respiratory disease caused by nvH1N1 infection. Alternatively, an increase in Th-1 and Th-17 cytokines may reflect a vigorous antiviral host response necessary for clearance of virus during severe lower respiratory infections.

I don't see what the fuss is about myself. Not nearly important on the topic as the animal work and the lack of effect of anti-inflammatory drugs in patients. Tim Vickers (talk) 20:52, 16 December 2009 (UTC)

Thanks for locating that link, Tim. It does seem that this study is extremely small, but at least it provides a clue for further investigation. The media are eager to latch on to anything that might answer the question of why the virus is so serious for a few while being fairly innocuous for most. Given that something in the region of 2/3 of the H1N1/09 patients put on ventilators don't survive, it is a very understandably human story, even if the science is still less than convincing. LeadSongDog come howl 15:53, 17 December 2009 (UTC)

Vitamin D claims to regulate cytokine (immune) responses

There are numerous claims online that vitamin D regulates cytokine (immunesystem) responses. Do these claims have any scientific research behind them? User:Nunamiut— Preceding unsigned comment added by 84.215.44.195 (talk) 13:24, 8 November 2009 (UTC)

There are numerous claims online that Bigfoot exists, flying saucers have landed and taken over the world or even that the same is true, save that we won and that E does NOT equal MC^2. Hence, one must examine studies (non exist in the REAL world, only a few claimed studies that were sponsored by the company seeking a claim of benefit), published articles (none, in peer reviewed publications) and fact. Overall, every part in a system plays a part, but, NONE can play a key, as they're interlocked systems. In this case, it is a cascade of signals causing an overreaction of immune response. No vitamin would relieve it, but stronger drugs MIGHT interrupt the cycle of increasing cascade.Wzrd1 (talk) 05:05, 3 February 2012 (UTC)

Actually there is very strong evidence that vitamin D has a profound influence on the immune system (PMID 20824663) including regulating the production of some cytokines. See for example PMID 11705327, PMID 16600924 ($\downarrow \!$TNF-α),PMID 12507780 ($\uparrow \!$TGF beta 1), PMID 15209957 ($\uparrow \!$IL-10), and PMID 22237768 ($\uparrow \!$IL-10). Boghog (talk) 07:51, 3 February 2012 (UTC)

Quite true, however in the context of a cytokine storm, vitamin D is useless. For general healthy people, vitamin D is good, for those with some immune dysfunctions (of a substantially lower degree of severity), it may be useful. For a cytokine storm or even SIRS, it would be useless and even potentially harmful.Wzrd1 (talk) 19:25, 3 February 2012 (UTC)

There is circumstantial evidence that vitamin D (see PMID 20592793) may reduce the incidence and/or severity of cytokine storm. Vitamin D boosts the innate immune system while damping the adaptive immune system in part by down regulating the production of pro inflammatory cyctokines. While there is no direct clinical evidence that vitamin D deficient patients are at greater risk of developing cytokine storm, there is strong mechanistic rationale. Finally, the name vitamin D is somewhat misleading. Vitamin D is a steroid derived substance that regulates the expression of thousands of genes (including several cytokine genes) through binding to and activating the nuclear hormone receptor VDR. Hence vitamin D is more of hormone than a vitamin. It only become a vitamin (i.e., must be supplied by the diet) if one is not exposed to enough sunlight. Boghog (talk) 16:00, 4 February 2012 (UTC)

Datedness on citations, general thought on overstating therapeutic tracks (subheadings under "Treatment")

The literature presented here on the various therapeutic tracks being researched is very old -- little if any beyond 2007, some on apparent major Treatment emphases with literature limited to 2003 (nearly a decade ago). For this reason, the tone and extent of each subheading under "Treatment" needs serious attention. Something of potential early drug discovery interest in 2003-2007, without clear further attention in the pharma conference literature at least, is likely of no continuing practical interest. (Pharma ideas and molecules "die on the vine" all the time; to include past possible therapeutic tracks that are only of historic interest is likely not appropriate for an encyclopedic article.) Moreover, there is reason to think that having little or nothing on therapeutic possibilities that are current, while listing those 5-10 years old, may actually be detrimental to the aims of wikipedia (insofar as dated scientific information can be misinformation, in its incompleteness and misdirection in relation to current opinion). Bottom lines: Update all under Treatment, etc., and reduce OX40 IG and ACE inhibitor sections if there is nothing substantial going on in these areas in 2013. LeProf — Preceding unsigned comment added by 67.175.245.235 (talk) 03:59, 24 December 2012 (UTC)

For lay-readers I think it would be valuable if someone knowledgeable (I'm not) would add a general disclaimer, such as the comment ^above^, to the top of the Treatments section. Where there are references to studies, dates could also be added in-line so that their relative age is more immediately apparent. It would be nice if the treatments were sorted by how "promising" they are considered to be currently (that's probably a lot to ask but I would hope that anyone with some genuine expertise could just boldly do it). DKEdwards (talk) 19:53, 4 February 2018 (UTC)

Relationship with vaccines

A common assertion made in opposition to vaccination has been that vaccines can cause a cytokine storm, leading to adverse events. See Kathleen Stratton, Andrew Ford, Erin Rusch, and Ellen Wright Clayton, eds., Adverse Effects of Vaccines: Evidence and Causality(2011), Chapter 3: Evaluating Biological Mechanisms of Adverse Events, stating that "subtle imbalances of proinflammatory and anti-inflammatory cytokines may occur following immunization against rubella, human papillomavirus, or hepatitis B" and that "it is possible that the unique immunogenetic makeup of an individual might predispose that individual to an exaggerated cytokine imbalance following immune stimulation such as microbial infection or vaccine administration", but concluding that a review of vaccine literature reveals "no evidence that directly or indirectly supports the oversecretion of cytokines as an operative mechanism". I think we should cover this. BD2412 T 01:31, 31 May 2021 (UTC)