IL-6 in the spotlight: From cardiovascular pathophysiology to therapy.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing mechanistic, genetic, and clinical literature.
PubMed 41340186 · doi:10.1111/eci.70161
What was done
This narrative review synthesized experimental, genetic (genome-wide association and Mendelian randomization), and clinical evidence examining the pathophysiological pathways, prognostic value, and therapeutic potential of interleukin-6 (IL-6) in cardiovascular disease, including early-phase and ongoing phase III clinical trials of IL-6-targeted therapies.
What was found
The abstract reports no quantitative values or effect estimates. It qualitatively reports that acute IL-6/STAT activation during myocardial infarction is cardioprotective, whereas persistent chronic activation—particularly via trans-signalling—promotes endothelial dysfunction, atherosclerosis, monocyte recruitment, coagulation, and myocardial fibrosis. Mendelian randomization studies support a causal relationship between IL-6 signalling and coronary artery disease, stroke, and atrial fibrillation. Elevated IL-6 levels predict adverse outcomes in acute coronary syndromes and heart failure, and pilot trial data indicate that pharmacological IL-6 inhibition reduces systemic inflammation with an acceptable safety profile.
Why it matters
Targeting IL-6 signalling represents a potential strategy to treat residual inflammatory risk in cardiovascular disease. This review frames the dual acute-versus-chronic biological role of IL-6 and highlights populations (such as those with chronic kidney disease or heart failure) targeted in ongoing outcome trials.
Limits
The abstract describes a narrative review without systematic search protocols, quality appraisal, or quantitative meta-analytic pooling. Definitive clinical cardiovascular efficacy and safety endpoints remain unestablished pending the completion of large phase III trials.
Cited by
- supports Interleukin-6 (IL-6) is a pro-inflammatory cytokine that plays an important role in systemic inflammation.