Fig. 4
From: Cellular and molecular features of COVID-19 associated ARDS: therapeutic relevance
Immunomodulation in COVID-19 targeting IL-1β and IL-6 pro-inflammatory signalling pathways. Anakinra is a soluble IL-1Ra that acting as a decoy receptor binds IL-1β and prevents the activation of its receptor. Tocilizumab is a monoclonal antibody against IL-6R, blocking IL-6 binding to it and Canakinumab is a monoclonal antibody that bind IL-1β preventing activation of its receptor. Baricitinib is a dual JAK1 and -2 blocker. All these drugs inhibit the activation of several intracellular pro-inflammatory signalling pathways that induce the gene expression and the release of several pro-inflammatory mediators during SARS-CoV-2 infection that develops into a “cytokines storm”. Abbreviations: AP-1: activator protein-1; IκBα: inhibitor of kappa light chain gene enhancer in B cells; IL: interleukin; JAK: janus kinase; MAPK: mitogen-activated protein kinase; NF-κB: nuclear factor kappa B; P:phosphate; RNA: ribonucleic acid; STAT: signal transducer and activator of transcription