Nash · Scandinavian journal of medicine & science in sports 2023 · narrative review · n=?

IL-6 signaling in acute exercise and chronic training: Potential consequences for health and athletic performance.

Level 5 - mechanism / opinion, no new human data

Narrative review of biological mechanisms and genetic variants without systematic methodology or original human data

PubMed 36168944 · doi:10.1111/sms.14241 · record verified 2026-08-26

What was done

This narrative review synthesizes evidence on the dual signaling pathways of interleukin-6 (IL-6) during acute exercise and chronic training. It describes the divergent mechanisms of classical signaling (via cell-surface membrane-bound receptors) versus trans-signaling (via soluble IL-6 receptors), and details the clinical and functional impact of the IL-6R single nucleotide polymorphism (SNP) rs2228145 on health and exercise performance.

What was found

The abstract reports no quantitative values or statistical comparisons. It details that IL-6 release from skeletal muscle increases with exercise duration, intensity, and muscle glycogen depletion. Classical signaling is highlighted as the primary pathway active during exercise, supporting energy homeostasis and exerting anti-inflammatory actions. In contrast, trans-signaling involves soluble IL-6 receptors (sIL-6R), possesses a longer half-life, acts across broad cell types, and mediates pathological inflammation. The rs2228145 SNP elevates circulating sIL-6R levels, shifting pathway balance toward trans-signaling and linking to conditions including rheumatoid arthritis, type 1 diabetes, and severe COVID-19.

Why it matters

The review provides a mechanistic framework explaining how exercise-induced IL-6 promotes metabolic adaptation and anti-inflammatory outcomes rather than systemic inflammation, while identifying genetic variations that could modulate individual responses to training and disease risk.

Limits

The paper is a non-systematic narrative review providing qualitative biological models rather than primary empirical data. The abstract lacks quantitative effect sizes, pooled metrics, participant numbers, and search criteria. Clinical and performance outcomes remain theoretical extrapolations of pathway biology rather than directly measured prospective endpoints.

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