{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T04:13:19Z","timestamp":1784434399414,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Patients who are severely affected by coronavirus disease 2019 (COVID\u201019) may develop a delayed onset \u2018cytokine storm\u2019, which includes an increase in interleukin\u20106 (IL\u20106). This may be followed by a pro\u2010thrombotic state and increased D\u2010dimers. It was anticipated that tocilizumab (TCZ), an anti\u2010IL\u20106 receptor monoclonal antibody, would mitigate inflammation and coagulation in patients with COVID\u201019. However, clinical trials with TCZ have recorded an increase in D\u2010dimer levels. In contrast to TCZ, colchicine reduced D\u2010dimer levels in patients with COVID\u201019. To understand how the two anti\u2010inflammatory agents have diverse effects on D\u2010dimer levels, we present data from two clinical trials that we performed. In the first trial, TCZ was administered (8\u2009mg\/kg) to patients who had a positive polymerase chain reaction test for COVID\u201019. In the second trial, colchicine was given (0\u00b75\u2009mg twice a day). We found that TCZ significantly increased IL\u20106, \u03b1\u2010Defensin (\u03b1\u2010Def), a pro\u2010thrombotic peptide, and D\u2010dimers. In contrast, treatment with colchicine reduced \u03b1\u2010Def and Di\u2010dimer levels. <jats:italic>In vitro<\/jats:italic> studies show that IL\u20106 stimulated the release of \u03b1\u2010Def from human neutrophils but in contrast to colchicine, TCZ did not inhibit the stimulatory effect of IL\u20106; raising the possibility that the increase in IL\u20106 in patients with COVID\u201019 treated with TCZ triggers the release of \u03b1\u2010Def, which promotes pro\u2010thrombotic events reflected in an increase in D\u2010dimer levels.<\/jats:p>","DOI":"10.1111\/bjh.17885","type":"journal-article","created":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T06:32:00Z","timestamp":1633761120000},"page":"923-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Divergent impacts of tocilizumab and colchicine in COVID\u201019\u2010associated coagulopathy: the role of alpha\u2010defensins"],"prefix":"10.1111","volume":"196","author":[{"given":"Suhair","family":"Abdeen","sequence":"first","affiliation":[{"name":"Department of Clinical Biochemistry Hadassah\u2010Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Abu\u2010Fanne","sequence":"additional","affiliation":[{"name":"Heart Institute Hillel Yaffe Medical Center Affiliated with Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"Bdeir","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Laboratory Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Maraga","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Hadassah\u2010Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Higazi","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry Hadassah\u2010Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas B.","family":"Cines","sequence":"additional","affiliation":[{"name":"Heart Institute Hillel Yaffe Medical Center Affiliated with Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology Haifa Israel"},{"name":"Medicine University of Pennsylvania\u2010Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel N.","family":"Heyman","sequence":"additional","affiliation":[{"name":"Department of Medicine Hadassah University Hospital, Mt. 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