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80 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 2 0 technique THE SOMATIC EDGE Understanding COVID-19's Cytokine Storm By Til Luchau So, what are cytokines and how can they kill? Does this help us understand anything about other kinds of inflammation? WHAT ARE CYTOKINES? When the body's immune cells detect pathogens or tissue damage, they secrete cytokines (Image 1) to signal, mobilize, and instruct other immune processes and cells. The word cytokine, in fact, comes from the Greek κύτος (kytos) or "cell," plus κίνησις (kinēsis) or "movement." Simplified, cytokines are cell movers. Though cytokines are relatively simple protein molecules, their complex functioning and interactions are still being deciphered. We know cytokines can be inflammatory (turning up immune processes); anti-inflammatory (turning off inflammation); or inflammation-resolving (by signaling "next" in the progression of normally self-resolving inflammatory phases that lead toward healing). In other words, cytokines orchestrate, modulate, and time each phase of normal inflammatory progression. Except in some cases, this orchestration goes very wrong. When a virus like COVID-19 infects the lungs, it hijacks cells there and turns them into virus factories. This damages the cells and releases inflammatory cytokines. These acute-phase cytokines have several important effects: • They painfully irritate nearby nerve endings, triggering the aches and pains typical of influenza (causing the host to modify its behavior, and rest). • They summon other immune cells (to attack the invader and damaged tissues). Cytokines are the immune system's inflammatory messengers and coordinators: when immune cells detect pathogens or tissue damage, they secrete cytokines to signal and regulate inflammatory cells and processes. 1 Although our understanding of how the coronavirus affects the body is still very incomplete (and changing rapidly), we do know the virus's effects vary tremendously from person to person. Some infected people have no symptoms at all; others have a cough and sore throat; some need medical care and may even die as their inflamed lungs and organs fail. Evidence is mounting that in a number of those fatal cases, it isn't the virus itself that kills the host, but rather, it is the body's own out-of-control inflammatory reactions, snowballing into a "cytokine storm" that deals the fatal blow.