Rethinking ASF control: Can we halt the ASF cytokine storm and save pigs

Abstract

African swine fever (ASF) remains a global threat to the pig industry, with high mortality rates and limited control options due to the absence of effective vaccines or treatments. This review proposes a therapeutic framework to manage ASF, targeting the excessive immune response known as the "cytokine storm," which leads to severe organ damage and death. Based on ASF progression timelines, fever typically appears 3-4 days into the infection. At this critical point targeted therapies such as anti-inflammatory agents could be administered at this critical stage to constrain the initial generation of cytokines in an attempt to delay a full blown cytokine storm. However, long-term use of anti-infammatories could dampen the pig’s immune response and so would need to be managed carefully. There is increased multi-organ damage leading to blood vessel permeability causing bleeding, which calls for blood anticoagulants to be used to prevent complications such as the blood clotting and fluid accumulation in vital organs such as in the lungs. The proposed therapeutic approach, synchronized with ASF progression, could help reduce mortality by modulating the immune response and managing complications.