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Adrenaline fuels a cytokine storm during immunotherapy

Attempts to boost the body’s antitumour immune responses can trigger a harmful inflammatory reaction called a cytokine storm. New insights into the mechanisms involved might help to prevent this problem.
  1. Stanley R. RIddell

    1. Stanley R. Riddell is at the Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.

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Many newly developed, potent cancer therapies aim to harness an immune response to target tumours1. However, a common problem with such immunotherapy approaches is the development of a severe inflammatory response called a cytokine storm2,3, in which levels of proteins called cytokines become abnormally high. This results in fever, low blood pressure, heart problems and, in some cases, organ failure and death. There is therefore great interest in understanding the underlying mechanisms to develop ways of preventing cytokine storms without altering the effectiveness of anticancer treatments. Writing in Nature, Staedtke et al.4 reveal that the protein ANP can block cytokine storms, and they uncover a self-amplifying production loop in immune cells that generates a class of molecule called catecholamines, which includes the hormone adrenaline (also known as epinephrine). They report that this catecholamine production helps to initiate and maintain cytokine storms.

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Nature 564, 194-196 (2018)

doi: https://doi.org/10.1038/d41586-018-07581-w

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Competing Interests

The author is an adviser for, holds equity in, and receives sponsored research support from Juno Therapeutics, a Celgene company; and has served as an adviser for Adaptive Biotechnologies, Cell Medica and Nohla.

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