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What Is a Cyotkine Storm?

Last modified on April 26th, 2024

During the COVID19, or SARS-CoV-2 pandemic, many scientific and medical terms have appeared in the headlines. People have become familiar with terms such as coronavirus, N95 respirator masks, and pandemics. 

Another term that has entered people’s vocabulary is “cytokine storm”. But what is a cytokine storm, and how is it linked to COVID19?

What Are Cytokines?

Cytokines are small proteins in the body. The body uses them to signal between cells. However, the activity of the cytokine may be different depending on what cells it is working on and what other cytokines are present. 

Different cytokines and cells work together in a complex signaling network that researchers are still trying to understand. Many different types of cytokines exist, such as:

Type of cytokine

Role in the body

Interferon

Regulate the immune system and help activate the body against viruses

Interleukins

Help white blood cells grow and can also cause inflammation

Chemokines

Help control cell movement and can also cause inflammation

Colony stimulating factors

Control the amount and type of blood cells produced by the bone marrow

Tumor necrosis factor

Helps regulate the immune system and can cause inflammation

What Is A Cytokine Storm?

A cytokine storm is an immune system overreaction. It often starts with inflammation at one site in the body and spreads. Inflammation often takes place in the early stages of an infection. Although people generally consider inflammation to be a bad thing, your body does it to try to fight illness. Inflammation plays several roles including causing increased:

-Blood flow, so that immune cells and nutrients can get to the site of infection

-Temperature, making it harder for bacteria to survive

-Pain, so that you are aware that there is a problem

However, the body can create too much inflammation. In turn, the inflammation can start to damage the surrounding tissue. 

For example, swelling can make it hard for blood to reach nearby tissues. 

Further, the infection that is triggering the inflammation can also damage nearby tissues. In severe cases, the tissue may not heal normally. Instead, the tissue can become fibrotic, or scarred.

How Does a Cytokine Storm Impact the Lungs?

A cytokine storm can impact the lungs by causing a condition called acute lung injury. In severe cases, acute lung injury is called acute respiratory distress syndrome, or ARDS. 

These syndromes can occur from different respiratory infections like the flu and COVID-19. A cytokine called interleukin-1β plays a major role in the development of the cytokine storm in the lungs. 

Scientists think that the immune system and cytokines react quickly and ferociously in some cases, causing a cytokine storm. Sometimes, cytokines like interferon-α/β can kill immune system cells like T cells which are trying to get rid of the virus. 

As such, the cytokine storm may even make a virus last longer than it otherwise would. In addition, interferon-α/β and interferon-gamma may kill healthy lung tissue, causing low blood oxygen levels. 

Following the cytokine storm, acute lung injury can occur when white blood cells take part in inflammation which is then followed by the development of scar tissue. Instead of healthy tissue, collagen gets deposited in the lungs. 

Unfortunately, the lungs are often not the only organ to be damaged, even if the cytokine storm is centered there.

What Health Problems Cause A Cytokine Storm?

Although the term has become well-known during the COVID-19 pandemic, COVID-19 is not the only cause. 

Cytokine storms are caused by a variety of diseases. They can occur from both infectious and non-infectious diseases. 

A cytokine storm may play a role in diseases as different as the flu, pancreatitis, an inflammatory condition of the pancreas, and multiple sclerosis, a neurological disorder. Sometimes, cytokine storms can even be caused by medical treatment of an underlying health problem.

Researchers think that some people are more susceptible to a cytokine storm than others. However, at this time, scientists are not sure why this occurs. 

One possibility is that there is a genetic difference in cellular receptors that help control the immune system. Unfortunately, there are currently no tests that can be done to tell whether one person is at a high risk of having a cytokine storm.  

Further, some researchers have found that some viral strains may be more likely to cause a cytokine storm than others. When a virus is highly pathogenic, it might cause cytokines to behave differently than they normally would for a viral infection.

How Do You Treat A Cytokine Storm?

Researchers are still trying to figure out the best way to treat a cytokine storm.

Finding treatments to block the cytokines has been difficult, because they bind to many different cells throughout the body in many different ways. Further, studies have shown that cytokines have redundancy. 

This means that even if one cytokine is blocked from working, others can take over. Doctors have tried many different drugs to treat cytokine storms. 

However, none have been shown to work well, and some have made patients even sicker than before. Treatments that have been tried include:

-Steroids

-Aspirin

-Monoclonal antibodies

-Drugs to block cytokines

-Statins

Supporting the Immune System Against A Cytokine Storm

Researchers are still studying the causes of cytokine storms as well as investigating treatments. However, clinicians are also aware of different factors that can support your immune system. This includes making sure you get sufficient Vitamin D.

Researchers think that Vitamin D may protect against cytokines that cause inflammation. By stopping these cytokines from causing excess inflammation, scientists think that Vitamin D may help prevent a cytokine storm. 

Vitamin D is believed to reduce the body’s production of immune system T helper 1 cells, which cause a pro-inflammatory cytokine cascade with tumor necrosis factor alpha, or TNFα, and interleukin-6 . 

Instead, Vitamin D promotes T helper 2 cells, which are linked to less inflammatory cytokines. Further, besides reducing TNFα, Vitamin D can reduce a chemical called nuclear factor kappa B, also known as NFκB. Research also suggests that Vitamin D supports the production of a chemical called CD31. 

This chemical leads the parts of the immune system that are linked to autoimmune diseases to respond less intensely.

Vitamin D has long been linked with respiratory health protection. Low levels of Vitamin D are linked to colds, flu and various infections. Specifically, vitamin D levels under 22.5 nmol/L are linked to lower respiratory tract infections. Studies also show lower rates of pneumonia among people with adequate sun exposure and Vitamin D.

How Do I Get Vitamin D?

Vitamin D is a fat-soluble vitamin. It is present in food, vitamins and is produced by the body after sun exposure.

Some of the best foods for Vitamin D include:

-Mushrooms

-Fish

-Dairy products

-Eggs

In general, the amount of Vitamin D that you need is determined by your age:

Age

Recommended Daily Vitamin D Intake (in International Units, or IU)

Birth to 1 year old

400 IU

1 to 70 years old

600 IU

71 years and older

800 IU

Your doctor will likely routinely check your Vitamin D levels in your lab work. Although the optimal Vitamin D level remains controversial, most doctors recommend a Vitamin D blood level of at least 30 ng/mL. 

Having a higher level is not necessarily better. For example, Vitamin D levels higher than 50 ng/mL have been linked to some health problems.

One of the best options for Vitamin D supplementation on Amazon.com is:

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Image Source: Amazon
  • Non-GMO
  • Vegetarian
  • Easy to use
  • No flavoring
  • Can be mixed with liquids or food

Liquid Vitamin D can be a good option for those who have problems swallowing tablets or capsules. 

This Carlson Vitamin D supplement is sold in a liquid form. Each drop gives 1000 IU of Vitamin D and the recommended dose is one drop daily. One benefit of liquid Vitamin D is that you have control over the dose that you take. 

For example, if your doctor asks you to take a standard Vitamin D supplement of 1000 IU daily, you can take a single drop. 

However, if your doctor recommends that you take a higher dose, you can take the corresponding number of drops. 

The drops can be mixed with liquid or food, or put directly in the mouth. The drops have a non-GMO label as they contain no genetically modified organisms. 

They are vegetarian friendly and contain no flavoring. The drops contain no dairy, gluten, preservatives or soy. Besides Vitamin D, the drops contain medium chain triglyceride oil derived from coconut and palm. 

The drops undergo potency testing from an FDA-registered lab.

A cytokine storm can be very dangerous. Doctors are still investigating possible treatment options, and scientists are looking into causes for this condition. 

By keeping healthy habits and making sure that your nutrient intake, including Vitamin D, is optimal, you may improve your overall immune system and respiratory health.

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author avatar
Dr. Jessica Pyhtila
Dr. Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, MD. She is a double board-certified Geriatric Pharmacist (BCGP) and a Pharmacotherapy Specialist (BCPS). She has a special practice interest in integrative and functional nutrition for optimal health.
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