Introduction:
Cytokines are proteins that regulate as well as mediated immunity, inflammation, and hematopoiesis. Cytokines are released when immune cells get stimulated. The basic structural components of cytokines comprise protein, but a few have sugar molecules attached. Cytokines with protein structures and sugar molecules attached are called glycoproteins. Cytokines are released from the body's defense cells, like white blood cells and macrophages. Cytokine influences the functional activity of the following inflammatory cells:
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Lymphocytes.
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Monocytes.
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Neutrophils.
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Fibroblast.
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Endothelial cells.
Cytokines play an important role in both acute and chronic inflammation. Cytokine storm is responsible for disease aggravation.
How Is Cytokine Storm Caused?
Cytokine storm is responsible for immune system pathology during viral infection. Whenever the human body is exposed to a virus, innate immunity comes into action. Well-coordinated human system response protects the human body from viral damage but excessive and aggravated immune response can, in turn, cause more severe damage to the human body. Cytokine storm results from an imbalance between the pro-inflammatory and inflammatory mechanisms. Interaction between different cell types and cytokines also aggravates the immune system.
Following are the sequelae of cytokine storm:
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Acute cardiac injury.
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Acute lung injury.
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Acute kidney injury.
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Central nervous system injury.
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Liver injury.
What Are the Stages of a Cytokine Storm?
Cytokine storm has been classified into the following stages:
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First Cytokine Wave: It is the initial step; in this step, the body recognizes the foreign body, and inflammatory defense cells are directed toward these foreign bodies.
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Cytolytic Cell Dysfunction: At this stage, the infectious agent count significantly increases, so the immune system reaction also speeds up. The blood test during this stage reveals a significant rise in the ESR values and cytokine levels.
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Lethal Second Wave: This is where the body's immune system starts acting against the body's self-cells. It is a severe type of hypersensitivity reaction. During the COVID-19 infection, the death rate was significantly related to this stage of the cytokine storm. The lungs of COVID-19-infected individuals had an excessive rise of inflammatory cell infiltrate that led to liquefaction necrosis of the lung tissues. Severe pulmonary infection decreased oxygen levels, and sudden death was associated with exaggerated immune responses to the virus in most individuals suffering from COVID-19.
What Are the Laboratory Tests Prescribed for Cytokine Storm Diagnosis?
The following tests are prescribed by the doctors in order to diagnose cytokine storm in an individual:
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Lymphopenia: Decrease in lymphocyte count; lowered levels of lymphocytes is a strong indicator of weak defense capacity of the body, and the infection can get severe.
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Thrombocytopenia: Deficiency of platelets in the blood. This indicates that the body's healing capacity has significantly lowered.
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High Levels of Ferritin: Increased ferritin level is a strong indicator of high oxidative stress. It is an indicator of increased inflammation.
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D-dimer Analysis: D-dimer is a protein pigment present in blood that is responsible for the maintenance of the viscosity of the blood. D-dimer levels significantly increase in cases of severe acute inflammation and are an indicator of active infection in the body.
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Aspartate Aminotransferase Levels: Increased Aspartate aminotransferase levels are a vital indicator of acute and chronic inflammation in the human body.
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Lactate Dehydrogenase Levels: These enzymes are associated with inflammatory cell release, and hence increase in lactate dehydrogenase enzyme indicates signs of inflammation in the body, and indirectly it refers to increased cytokine levels in the body.
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C-Reactive Protein Levels: An increase in these protein levels are a sign of an increased immune reaction, and it is also an indicator of an inflammatory reaction in the body.
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Neutrophil Count: Neutrophil count significantly increases during the early stages of inflammation.
These tests provide the warning sign for cytokine storms. The clinicians should co-relate the clinical symptoms and laboratory findings and plan a definite treatment.
What Information Should be Given to The Doctor Before Starting the Treatment for Cytokine Storm?
Whenever an individual visits a doctor for the management of benign prostate enlargement, the following pieces of information should be given to the doctor:
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Family History: The patient should inform the doctor if any family members, like their parents, are suffering from diabetes mellitus (increased blood glucose levels), hypertension (increased blood pressure), hypotension, or renal and hepatic disorder. They should also disclose if their siblings or other family member has any history of underlying medical conditions. This information helps the doctors know the disorder's hereditary pattern and the common signs and symptoms that run in the individual's family. Family history of the disorder guides the doctor in planning a better management and treatment protocol.
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Personal History: Personal history includes altered symptoms that an individual faces, like excessive weight gain or weight loss, drowsiness, lethargy, swollen legs, increased heart rate, increased thirst, increased urge to eat food, and increased or reduced urination.
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Other Systemic Disorders: The patient should always inform the doctors if they are suffering from other underlying diseases like kidney disorders or liver dysfunction. Doctors prescribe medications keeping in consideration the other underlying systemic conditions.
What Are the Natural Practices to Prevent Cytokine Storms?
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Deleterious activities like cigarette smoking and alcohol intake significantly influence immune health. It has a negative impact on the health of all individuals. Various studies have noted the effect of cigarette smoking on lung disorders, decreased body defense mechanisms, and reproductive health as well. Therefore, it is advised that immunocompromised people should abstain from alcohol intake and cigarette smoking to improve their immunity.
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Psychological stress is another important factor influencing immune health. Psychological stress causes hormonal imbalance. These hormonal imbalances directly affect the well-being of an individual. Proper stress management is advisable in these females to improve their immune health. Antidepressants and family support can help relieve stress.
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High consumption of junk food leads to increased deposition of toxins in these individuals. Increased polyunsaturated fatty acid levels and lipid levels have a negative impact on immune health.
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Obesity is also noted to have a negative impact on individuals of all age groups. Maintaining an appropriate body mass index is of utmost importance.
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Nutritional deficiency is also an important factor linked with decreased immunity.
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Antioxidant-rich food items like fruit and vegetables should be included in daily diet. Antioxidants help in washing out toxins from the body, which results in an improvement in immunity.
Conclusion:
Cytokines are proteins that regulate as well as mediated immunity, inflammation, and hematopoiesis. Cytokines are released when immune cells get stimulated. The patient should always inform the doctors if they suffer from other underlying diseases like kidney disorders or liver dysfunction. Doctors prescribe medications keeping in consideration the other underlying systemic conditions. Cytokines play an important role in both acute and chronic inflammation. Cytokine storm is responsible for disease aggravation.