Itolizumab, an anti-CD6 monoclonal antibody, as a potential treatment for COVID-19 complications

Expert Opin Biol Ther. 2020 Sep;20(9):1025-1031. doi: 10.1080/14712598.2020.1798399. Epub 2020 Jul 29.


Introduction: The globally rampant SARS CoV-2 pandemic requires novel medical strategies to control the severity of disease and death due to complications. Of the 15-20% patients that develop pulmonary symptoms, a sub-set develops an acute respiratory distress syndrome (ARDS) rapidly progressing into a critical condition. Marked elevation of cytokines/chemokines is observed with elevation of additional markers of inflammation, coagulation, and organ damage such as CRP, D-dimer, LDH, Ferritin and Troponin-I. This hyperinflammation leads to worsening of oxygen saturation due to pulmonary infiltration and exudation, organ damage, and dysfunction of coagulation pathway and may lead to multi-organ failure.

Areas covered: The role of anti-inflammatory monoclonal antibodies such as Itolizumab, in cytokine storm.

Expert opinion: Itolizumab, an anti-CD6 humanized IgG1 mAb, binds to domain-1 of CD-6 that is responsible for priming, activation, and differentiation of T-cells. Itolizumab significantly reduces T-cell proliferation along with substantial downregulation of the production of cytokines/chemokines. Approved for moderate to severe chronic plaque psoriasis in 2013 it is currently being studied for addressing COVID-19 related cytokine storm and its complications. This article reviews its use in COVID-19 infections; its dose, administration protocol, contra-indications, and safety in treating moderate-to-severe ARDS by preventing and treating the cytokine storm and its complications.

Keywords: Anti-CD6; COVID-19; Itolizumab; cytokine storm; inflammatory; monoclonal antibodies; plaque psoriasis.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antigens, CD / immunology*
  • Antigens, Differentiation, T-Lymphocyte / immunology*
  • Betacoronavirus*
  • COVID-19
  • Cell Differentiation / drug effects
  • Cell Differentiation / physiology
  • Cell Proliferation / drug effects
  • Cell Proliferation / physiology
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology*
  • Cytokines / antagonists & inhibitors
  • Cytokines / immunology
  • Humans
  • Lymphocyte Activation / drug effects
  • Lymphocyte Activation / physiology
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology*
  • SARS-CoV-2
  • T-Lymphocytes / drug effects
  • T-Lymphocytes / immunology
  • Treatment Outcome


  • Antibodies, Monoclonal, Humanized
  • Antigens, CD
  • Antigens, Differentiation, T-Lymphocyte
  • CD6 antigen
  • Cytokines
  • itolizumab