Prevenzione della polmonite indotta da COVID-19 con terapia anti-citochinica
Giovanni Monteleone; Pier Carlo Sarzi-Puttini; Sandro Ardizzone.
Immune-mediated disorders are a group of disabling conditions that affect millions of individuals worldwide.These pathologies include, but are not limited to, rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel diseases. Each of these diseases has a unique epidemiology and pathophysiology, despite sharing several pathways of tissue damage, which rely on an excessive cytokine response. Indeed, cytokine blockers, such as infliximab, adalimumab (anti-tumor necrosis factor [TNF]), and ustekinumab (anti-interleukin [IL]-12/IL-23 [p40 subunit]), used for the treatment of psoriasis, rheumatoid arthritis, and inflammatory bowel diseases, are used with success for inducing and maintaining remission. Unfortunately, however, the use of these therapies enhances the risk of bacterial and viral infections, and of viral reactivation in cases with previous viral infection. With the recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the increasing incidence of associated coronavirus disease 2019 (COVID-19) in countries where immune-mediated disorders are frequent, the use of these drugs poses major challenges for clinicians.