The Controversies Surrounding Tocilizumab Administration Following Pathogen-Associated Molecular Pattern (PAMP) Induced by COVID-19

Shayesteh   Gheibi; Farhad Najmeddin; Bita   Shahrami; Kourosh   Sadeghi; Mojtaba   Mojtahedzadeh

doi:10.18502/jpc.v8i3.4549

Shayesteh Gheibi
Farhad Najmeddin
Bita Shahrami
Kourosh Sadeghi
Mojtaba Mojtahedzadeh

DOI: https://doi.org/10.18502/jpc.v8i3.4549

Keywords: Tocilizumab; Betacoronavirus; Coronavirus Infections; COVID-19; Pathogen-Associated; Molecular Pattern;

Abstract

A new corona virus disease (COVID-19) has affected more than 17 million people worldwide so far, and has become a global pandemic. Since there is no definitive cure for this life threatening disease, many clinical studies are in progress in this regard. Pathogen-associated molecular patterns (PAMP) prompting by coronavirus seems to generate cellular, structural, and functional derangements induced by immune dysregulation as well as many biological abnormalities including cytokine storm. The role of IL-6 in viral pneumonia and also its inhibition impact on the prevention of organ damage are still unknown.IL-6 seems to behave as a double blade evil cytokine, by playing a valuable role in cell to cell natural physiological communication. Tocilizumab, as an inhibitor of interleukin (IL)-6, may interrupt the paracrine system while causing dissemination of bacterial, fungal, and other viral infections, especially COVID-19, who are at a high-risk for development of sepsis and life-threatening superinfection.