An adaptable in vitro cytokine release assay (CRA): Susceptibility to cytokine storm in COVID-19 as a model

Translational in vitro models such as cytokine release assay (CRA) are essential to assess the susceptibility to cytokine storm or CRS in a non-interventional manner in a human in vitro laboratory setting. Such models are also helpful to unravel disease mechanisms, to study the effects of new therapeutics and vaccines thereon and to diagnose or monitor diseases. Such assay will be important in predicting, planning and preparing for hospital intensive care units that are needed during the course of a pandemic. We present a CRA that can be adapted for assessing acute cytokine release risk against viral antigens, and potentially be used for cytokine storm simulation in viral infection outbreaks. We have used SARS-CoV-2 antigens and COVID-19 as a model. The assay can be challenged by changed or mutated forms of a virus in follow on waves of the epidemic and it can easily be modified for other future pandemics. We show that the membrane protein of SARS-CoV-2 is playing a major role in cytokine release (CR), mainly that of IL-6, IFNγ, TNFα and IL-8, that may be associated with COVID-19. These results are in agreement with recent clinical findings and new vaccine designs.