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Publication : Disruption of a self-amplifying catecholamine loop reduces cytokine release syndrome.

First Author  Staedtke V Year  2018
Journal  Nature Volume  564
Issue  7735 Pages  273-277
PubMed ID  30542164 Mgi Jnum  J:268159
Mgi Id  MGI:6260235 Doi  10.1038/s41586-018-0774-y
Citation  Staedtke V, et al. (2018) Disruption of a self-amplifying catecholamine loop reduces cytokine release syndrome. Nature 564(7735):273-277
abstractText  Cytokine release syndrome (CRS) is a life-threatening complication of several new immunotherapies used to treat cancers and autoimmune diseases(1-5). Here we report that atrial natriuretic peptide can protect mice from CRS induced by such agents by reducing the levels of circulating catecholamines. Catecholamines were found to orchestrate an immunodysregulation resulting from oncolytic bacteria and lipopolysaccharide through a self-amplifying loop in macrophages. Myeloid-specific deletion of tyrosine hydroxylase inhibited this circuit. Cytokine release induced by T-cell-activating therapeutic agents was also accompanied by a catecholamine surge and inhibition of catecholamine synthesis reduced cytokine release in vitro and in mice. Pharmacologic catecholamine blockade with metyrosine protected mice from lethal complications of CRS resulting from infections and various biotherapeutic agents including oncolytic bacteria, T-cell-targeting antibodies and CAR-T cells. Our study identifies catecholamines as an essential component of the cytokine release that can be modulated by specific blockers without impairing the therapeutic response.
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