Dr. David Fajgenbaum was a medical student in excellent health when he was struck with a mysterious disease. He nearly died before his doctors finally diagnosed him with a rare condition known as idiopathic multicentric Castleman disease. They hardly knew anything about it, and the few treatments that were available didn’t work for him. So he dedicated himself to finding a medication that did work. It turned out that an existing immune-suppressing drug called sirolimus was successful at suppressing the cytokine storms that put his life at risk.
One way that COVID-19 is killing people in this pandemic is by triggering the immune system. When it overreacts, the result is what doctors call cytokine storm. This causes high fevers, lung damage and terrifying respiratory distress. Cytokine storm or a similar immune overreaction may also help bring on MIS-C. (Multisystem Inflammatory System in Children) This is a complication affecting babies, children and young adults, in which multiple organ systems begin to fail. When immune system cells release a lot of cytokines, these pro-inflammatory compounds can also push blood to clot and harm organs throughout the body.
Dr. Fajgenbaum has been leading a collaborative that is doing research on treatments for Castleman disease. He found himself thinking that someone should apply that research to help treat severe cases of COVID-19. When he didn’t see anyone else doing so, he realized he and his team had the skills and knowledge needed. Consequently, following his motto of turning hope into action, they went to work. Dr. Fajgenbaum shares this perspective and the progress they have made so far.
David Fajgenbaum, MD, MBA, MSc, is an assistant professor of medicine in the department of Translational Medicine & Human Genetics at the University of Pennsylvania. In addition, he is Associate Director for Patient Impact of the Orphan Disease Center at the University of Pennsylvania. His book is Chasing My Cure: A Doctor's Race to Turn Hope Into Action.
A patient who has experienced five cytokine storms similar to those caused by COVID-19 before identifying a drug to save his life, Fajgenbaum is also the Executive Director of the Castleman Disease Collaborative Network (CDCN) and Principal Investigator of the CORONA project. Dr. Fajgenbaum's work has been highlighted extensively, including a cover story in the New York Times and the Forbes “30 Under 30” list. The website for the book is https://chasingmycure.com/ while the website for the CORONA project is https://cdcn.org/corona/