Figures
Figure 1. Hypothetical model of dexamethasone mode of
action involving inhibition of the cytokine storm and induction of
proresolving lipids such as Protectin D1 (PD1) and Resolvin D4.SARS-CoV2 infection induces hyperinflammation characterized by a
‘cytokine storm’ involving TNF, IL-1, Il-6, IL-8 and IP-10 production
and release of eicosanoids. SARS-CoV2 infection also induces
proresolving meditators including protectins, resolvins and maresins as
an effort to counter-balance the system. These act to reduce
inflammation and promote its resolution but are also help resolve
coagulation and block viral replication. Strengthening this response
through the temporal administration of dexamethasone which triggers in
addition to its conventional anti-inflammatory effects the D-series
protectins results in notable benefit in patients.