A subgroup of patients with severe COVID-19 may have a cytokine storm syndrome.
A cytokine profile in severe COVID-19 disease includes increased interleukin (IL)-2, IL-7, granulocyte-colony stimulating factor, interferon-gamma inducible protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1-alpha, tumour necrosis factor-alpha, and IL-6. Mortality might be due to virally driven hyperinflammation.
Anti-IL-6 antibody tocilizumab (IL-6 receptor blocker) has been used in patients with COVID-19 pneumonia and elevated IL-6. Other agents, such as sarilumab and siltuximab, which also target the IL-6 pathway, are being evaluated in clinical trials.
Wim Hof Method decreases IL-6, can it prevent IL-6-induced cytokine storm in COVID19?
Traditionally, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced, hence the name "autonomic", independent, from voluntary influence.
The mainstay of the Wim Hof Method is a 20-minute meditation centered around a breathing technique (cyclic hyperventilation followed by breath retention). In a small study of 24 patients (12 in the intervention arm vs 12 controls), levels of proinflammatory mediators TNF-alpha, IL-6, and IL-8 were lower in the intervention group. There was a large increase in the IL-10 levels in the intervention group. See figure 4 here: https://www.pnas.org/content/pnas/111/20/7379/F4.large.jpg, https://www.pnas.org/content/111/20/7379
A video of a study participant from the article is embedded below:
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COVID-19: consider cytokine storm syndromes and immunosuppression. Puja Mehta et al. Lancet, 2020,
Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Matthijs Kox et al. PNAS May 20, 2014 111 (20) 7379-7384; first published May 5, 2014 https://doi.org/10.1073/pnas.1322174111
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