Hyperinflammation after anti-SARS-CoV-2 mRNA/DNA vaccines successfully treated with anakinra: Case series and literature review.
Exp Biol Med (Maywood)
; 247(4): 338-344, 2022 02.
Article
in English
| MEDLINE | ID: covidwho-1649460
ABSTRACT
The current SARS-CoV-2 pandemic diffused worldwide has encouraged the rapid development of vaccines to counter the spread of the virus. At present in Italy, 75.01% of the population completed the vaccination course (AIFA.gov.it) and very few adverse events have been recorded by now. Side-effects related to a theoretical over-reaction of the immune system in response to vaccines administration have been described, and the possibility that an autoimmune or a hyperinflammatory condition may occur was recently observed. Herein, we report four cases of hyperinflammatory syndrome with features indicative of Adult-onset Still's disease (AOSD) and macrophage activation syndrome (MAS), occurred after anti-SARS-CoV-2 vaccine injection and seen at our Unit between March and May 2021. Since interleukin (IL)-1 is one of the pivotal cytokines involved in AOSD pathogenesis, the inhibition of IL-1 is crucial in ameliorating the clinical symptoms of those patients. Moreover, it has been highlighted the central role of IL-1 as a hallmark of the hyperinflammatory status elicited by SARS-CoV-2 infection. In this case series, we successfully employed the IL-1 receptor antagonist anakinra to curb the cytokine release likely unleashed by the vaccine stimulation in potentially predisposed subjects. We also made a literature search to detect other patients with hyperinflammation temporally related to vaccines injection who benefited from IL-1 inhibition, while other AOSD/MAS-like described syndromes improved with other immunomodulatory strategies.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Interleukin 1 Receptor Antagonist Protein
/
COVID-19 Vaccines
/
MRNA Vaccines
/
Inflammation
Type of study:
Case report
/
Prognostic study
/
Reviews
Topics:
Vaccines
/
Variants
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Exp Biol Med (Maywood)
Journal subject:
Biology
/
Physiology
/
Medicine
Year:
2022
Document Type:
Article
Affiliation country:
15353702211070290
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