{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:24:48Z","timestamp":1787117088453,"version":"build-2736575974"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    We describe the case of a young female who presented with apparent human metapneumovirus-associated illness and dehydration, but whose condition rapidly worsened with progression to multiple organ dysfunction syndrome (MODS). Multiple modalities were used to treat the patient, including: 1) extracorporeal life support (ECLS) for refractory shock; 2) anakinra, a human recombinant interleukin (IL)-1 receptor antagonist, for presumed cytokine storm; and 3) therapeutic plasma exchange (TPE) for thrombocytopenia-associated multiple organ failure (TAMOF). The patient\u2019s organ dysfunction rapidly improved.\n                    <jats:italic>Post hoc<\/jats:italic>\n                    cytokine analysis revealed that anakinra administration was associated with marked decreases in interleukin (IL)-6 and IL-8 levels, but not in other cytokine biomarkers, indicating a possible upstream IL-1 effect on IL-6\/IL-8 levels. Preclinical cytokine-based sepsis models were used to investigate this possibility. The preclinical results suggest that IL-6 levels are a function of synergistic IL-1 and tumor necrosis factor (TNF) activity. Further study is needed to determine appropriate patient populations, timing, and dosing of anakinra for suppressing IL-1 signaling during cytokine storm-induced MODS.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1904924","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:35:46Z","timestamp":1787114146000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of anakinra on cytokine storm during sepsis-induced multiple organ dysfunction syndrome: case report and preclinical investigation"],"prefix":"10.3389","volume":"17","author":[{"given":"Rebecca M.","family":"Blade","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah P.","family":"Lecher","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M.","family":"Umstead","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Penn State College of Medicine","place":["Hershey, PA, United States"]},{"name":"Pulmonary Immunology and Physiology Laboratory, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zissis C.","family":"Chroneos","sequence":"additional","affiliation":[{"name":"Pulmonary Immunology and Physiology Laboratory, Penn State College of Medicine","place":["Hershey, PA, United States"]},{"name":"Division of Neonatal-Perinatal Medicine, Penn State College of Medicine","place":["Hershey, PA, United States"]},{"name":"Department of Cell and Biological Systems, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cainan","family":"Riccio-Baum","sequence":"additional","affiliation":[{"name":"Department of Cell and Biological Systems, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Rameeza","family":"Allie","sequence":"additional","affiliation":[{"name":"Department of Cell and Biological Systems, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Hahn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology, Penn State College of Medicine","place":["Hershey, PA, United States"]},{"name":"Dysregulated Immune Response Team (DIRT), Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"McKeone","sequence":"additional","affiliation":[{"name":"Dysregulated Immune Response Team (DIRT), Penn State College of Medicine","place":["Hershey, PA, United States"]},{"name":"Division of Pediatric Hematology and Oncology, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica E.","family":"Ericson","sequence":"additional","affiliation":[{"name":"Dysregulated Immune Response Team (DIRT), Penn State College of Medicine","place":["Hershey, PA, United States"]},{"name":"Division of Pediatric Infectious Disease, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"DeMartini","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Spear","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Penn State College of Medicine","place":["Hershey, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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