Evidence map›Paper›PMID 33521616›Full record

ReviewJournal of translational autoimmunity2021

Disruption of CCR5 signaling to treat COVID-19-associated cytokine storm: Case series of four critically ill patients treated with leronlimab.

Nicholas Agresti, Jacob P Lalezari, Phillip P Amodeo, Kabir Mody, Steven F Mosher, Harish Seethamraju, Scott A Kelly, Nader Z Pourhassan, C David Sudduth, Christopher Bovinet and 7 more

Open access · goldAbstract readReview
In one paragraph

Review in Journal of translational autoimmunity, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. NK Cells: A Powerful Squad Versus SARS-CoV-2.International journal of molecular sciences · 2025
    Review
  5. Article
  6. Review
  7. Article
  8. 5-HTJournal of advanced research · 2025
    Article
  9. Review
  10. Review
  11. Review
  12. Article
  13. Article
  14. Article
  15. The Immune Response ofInternational journal of molecular sciences · 2024
    Article
  16. Article
  17. Article
  18. Article
  19. COVID-19 Therapeutics: Use, Mechanism of Action, and Toxicity (Vaccines, Monoclonal Antibodies, and Immunotherapeutics).Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2023
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 5 institutions in 1 country.

Nicholas AgrestiSoutheast Georgia Health System, 2415 Parkwood Drive, Brunswick, GA, 31520, USA.
Jacob P LalezariCytoDyn, 1111 Main Street, Suite 660 Vancouver, WA, 98660, USA.
Phillip P AmodeoSoutheast Georgia Health System, 2415 Parkwood Drive, Brunswick, GA, 31520, USA.
Kabir ModyMayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 3222, USA.
Steven F MosherSoutheast Georgia Health System, 2415 Parkwood Drive, Brunswick, GA, 31520, USA.
Harish SeethamrajuMontefiore Medical Center, Albert Einstein University, 1695A Eastchester Rd, Bronx, NY, 10467, USA.
Scott A KellyCytoDyn, 1111 Main Street, Suite 660 Vancouver, WA, 98660, USA.
Nader Z PourhassanCytoDyn, 1111 Main Street, Suite 660 Vancouver, WA, 98660, USA.
C David SudduthSoutheast Georgia Health System, 2415 Parkwood Drive, Brunswick, GA, 31520, USA.
Christopher BovinetSpine Center of Southeast Georgia, 1111 Glynco Pkwy Ste 300, Brunswick, GA, 31525, USA.
Ahmed E ElSharkawiSoutheast Georgia Health System, 2415 Parkwood Drive, Brunswick, GA, 31520, USA.
Bruce K PattersonIncellDx, 1541 Industrial Rd, San Carlos, CA, 94070, USA.
Reejis StephenSoutheast Georgia Health System, 2415 Parkwood Drive, Brunswick, GA, 31520, USA.
Jonah B SachaVaccine and Gene Therapy Institute and Oregon National Primate Research Center, Oregon Health and Science University, 505 N.W. 185th Avenue, Beaverton, OR, 97006, USA.
Helen L WuVaccine and Gene Therapy Institute and Oregon National Primate Research Center, Oregon Health and Science University, 505 N.W. 185th Avenue, Beaverton, OR, 97006, USA.
Seth A GrossNYU Langone Gastroenterology Associates, 240 East 38th Street, 23rd Floor New York, NY, 10016, USA.
Kush DhodyAmarex Clinical Research, 20201 Century Blvd, Germantown, MD, 20874, USA.
Southeast Georgia Health System · USOregon Health & Science University · USIncell Corporation (United States) · USMontefiore Medical Center · USWinnMed · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronavirus disease 2019 (COVID-19) is associated with considerable morbidity and mortality. The number of confirmed cases of infection with SARS-CoV-2, the virus causing COVID-19 continues to escalate with over 70 million confirmed cases and over 1.6 million confirmed deaths. Severe-to-critical COVID-19 is associated with a dysregulated host immune response to the virus, which is thought to lead to pathogenic immune dysregulation and end-organ damage. Presently few effective treatment options are available to treat COVID-19. Leronlimab is a humanized IgG4, kappa monoclonal antibody that blocks C-C chemokine receptor type 5 (CCR5). It has been shown that in patients with severe COVID-19 treatment with leronlimab reduces elevated plasma IL-6 and chemokine ligand 5 (CCL5), and normalized CD4/CD8 ratios. We administered leronlimab to 4 critically ill COVID-19 patients in intensive care. All 4 of these patients improved clinically as measured by vasopressor support, and discontinuation of hemodialysis and mechanical ventilation. Following administration of leronlimab there was a statistically significant decrease in IL-6 observed in patient A (p=0.034) from day 0-7 and patient D (p=0.027) from day 0-14. This corresponds to restoration of the immune function as measured by CD4+/CD8+ T cell ratio. Although two of the patients went on to survive the other two subsequently died of surgical complications after an initial recovery from SARS-CoV-2 infection.

Indexed as

ACE2, angiotensin-converting enzyme 2Acute respiratory distress syndrome (ARDS)ALT, alanine aminotransferaseARDS, acute respiratory distress syndromeAST, aspartate aminotransferaseBID, bis in die (twice a day)CCL2, chemokine C–C motif ligand 2CCL3, chemokine C–C motif ligand 3CCL4, chemokine C–C motif ligand 4CCL5, chemokine C–C motif ligand 5CCR1, C–C chemokine receptor type 1CCR5, C–C chemokine receptor type 5CDC, Centers for Disease ControlCK, creatine kinaseCOPD, chronic obstructive pulmonary diseaseCoronavirus disease 2019 (COVID-19)COVID-19, coronavirus disease 2019CRP, C-reactive proteinCXCL10, chemokine C-X-C motif ligand 10CXCL2, chemokine C-X-C motif ligand 2DPP4, dipeptidyl peptidase-4DVT, deep vein thrombosisEDTA, ethylenediaminetetraacetic acideIND, emergency investigational new drug applicationFDA, Food and Drug AdministrationFi02, fraction of inspired oxygen, IgG4hemophagocytic lymphohistiocytosis, HTNHydroxychloroquine, HLHhypertension, ICUimmunoglobulin G4, HCQintensive care unit, IL-1βinterferon gamma, IL-6interferon gamma-inducible protein (IP) 10 or CXCL10, LOAinterleukin 1 beta, IFN-ƴinterleukin 6, IP-10Leronlimab (PRO 140)letter of authorization, MCPmacrophage colony-stimulating factor encoded by the CCL22 gene, MERS-CoVmacrophage colony stimulating factor, MDC (CCL22)macrophage Inflammatory Proteins 1-alpha, MIP-1βmacrophage Inflammatory Proteins 1-beta, N/AMiddle East respiratory syndrome coronavirus, MIGmonocyte chemoattractant protein, M-CSFmonokine induced by IFN-γ (interferon gamma), MIP-1αNational Early Warning Score, NKnatural killer, OSAnot applicable, NEWS2obstructive sleep apnea, PDGF-AAper os (taken by mouth), RANTESplatelet-derived growth factor AA/BB, PEEPplatelet-derived growth factor AA, PDGF-AA/BBpositive end-expiratory pressure, PNApulmonary nodular amyloidosis, poregulated on activation, normal T expressed and secreted (also known as CCL5)RO, receptor occupancyRT–PCR, reverse transcriptase polymerase chain reactionSARS-CoV-2SARS-CoV-2, severe acute respiratory syndrome coronavirus 2SARS-CoV, severe acute respiratory syndrome coronavirusTGF- α, transforming growth factor alphaTNF-α, tumor necrosis factor alphaTNF-β, tumor necrosis factor betaT-reg RO, regulatory T cells – receptor occupancyTregs, regulatory T cellsVEGF-A, vascular endothelial growth factor AWBC, white blood cellWHO, World Health Organization

Identifiers

PMID33521616
PMCPMC7823045
OpenAlexW3119318585

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.