Fig. 3

Proposed pathomechanism of CRS. Activation of manly T cells or lysis of immune cells induces a release of interferon gamma (IFN-γ) or tumor necrosis factor alpha (TNF-α). This leads to the activation of macrophages, dendritic cells, other immune cells and endothelial cells. These cells further release proinflammatory cytokines. Importantly, macrophages and endothelial cells produce large amounts of interleukin 6 (IL-6) which in a positive feedback loop manner activates T cells and other immune cells leading to a cytokine storm. Abbreviations: CAR: chimeric antigen receptor; FiO2: fraction of inspired oxygen; IL-6: interleukin 6; IFN-γ: interferon gamma; TNF-α: tumor necrosis factor alpha