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Autocrine macrophage activation. The hallmark of pathogenesis of macrophage activation syndrome, as can be seen in COVID-19, is the overproduction of IL-1β by tissues macrophages. IL-1β, as well as other proinflammatory cytokines, acts through autocrine stimulation on macrophages leading to a vicious cycle of cytokine production and hyperinflammation. gp130, glycoprotein 130; IFN, interferon; IL, interleukin; R, receptor; TLR, toll-like receptor; TNF, tumor necrosis factor.
