IL-6 in the spotlight: From cardiovascular pathophysiology to therapy

Area of Science:

• Cardiovascular Science
• Immunology
• Molecular Biology

Background:

• Interleukin-6 (IL-6) is a cytokine involved in immune and metabolic regulation.
• Persistent IL-6 activation, especially via trans-signalling, contributes to endothelial dysfunction, atherosclerosis, and myocardial fibrosis.

Purpose of the Study:

• To review evidence on IL-6's role in cardiovascular disease (CVD).
• To explore IL-6's molecular pathways, prognostic value, and therapeutic potential in CVD.

Main Methods:

• Comprehensive review of experimental, genetic, and clinical evidence.
• Analysis of genome-wide association studies and clinical trials, including IL-6-targeted interventions.

Main Results:

• Acute IL-6 signalling is protective in myocardial infarction, while chronic activation causes maladaptive myocardial changes.
• IL-6 promotes vascular inflammation, monocyte recruitment, coagulation, and fibrosis, with causal links to coronary artery disease, stroke, and atrial fibrillation.
• Elevated IL-6 predicts adverse outcomes in acute coronary syndromes and heart failure; IL-6 inhibition shows promise.

Conclusions:

• IL-6 exhibits a dual role: protective/pathogenic and acute/chronic.
• Chronic IL-6 links inflammation and metabolic issues to cardiovascular damage, necessitating context-specific therapies.
• Ongoing trials will determine if IL-6 blockade can be integrated into CVD prevention and management.