Question

A cytokine storm, or hypercytokinemia, is a condition where cytokines are released that trigger the release of other cytokines to develop a positive feedback loop. It is thought that the 1917-1918 Influenza pandemic induced a cytokine storm in its victims. Which of the following mechanisms would be BEST to stop the positive feedback loop created by a cytokine storm?

1) The use of soluble antagonists to bind soluble cytokines
2) The use of soluble antagonists to bind membrane-bound cytokine receptors
3) Infecting the patient with other viruses that are known to target and kill immune cells
4) Treating the patient with drugs that kill all immune cells
5) Nothing can be done for the patient.

Answer 1

The best method to halt a cytokine storm is to use soluble antagonists to bind soluble cytokines (option 1), thereby stopping the excessive immune activation without compromising the entire immune system.

Step-by-step explanation:

A cytokine storm occurs when an excessive release of cytokines triggers a self-propagating cycle of immune activation, leading to potentially life-threatening symptoms such as fever, inflammation, and shock. The question explores the best method to interrupt this positive feedback loop. The ideal approach would harness a mechanism to directly impede the interaction between cytokines and their receptors without causing collateral damage to the patient.

Among the provided options, the most effective mechanism would be to use soluble antagonists to bind to soluble cytokines (option 1). Soluble antagonists are molecules that can latch onto the cytokines in circulation, preventing them from engaging with cell receptors and thereby halting the cytokine-mediated signaling cascade. This intervention allows the immune system to regain balance without completely eradicating immune cells, which would leave the patient vulnerable to infections and other immune challenges.

In contrast, using soluble antagonists to bind membrane-bound cytokine receptors (option 2) might not be as effective since it does not reduce the circulating cytokine levels that are driving the storm. Infecting the patient with other viruses (option 3) or treating the patient with drugs that kill all immune cells (option 4) could be highly detrimental by introducing new health risks or eliminating the patient's immune defense. Clearly, doing nothing (option 5) is not an effective response when medical interventions can save lives.

Thus, the best mechanism to stop the positive feedback loop created by a cytokine storm would be the use of soluble antagonists to bind soluble cytokines and prevent further cytokine release.