Department of Immunology, School of Public Health, Tehran University of Medical Sciences, International Campus, TUMS-IC, Tehran, Iran; Department of Medical Microbiology, Faculty of Clinical Science, College of Health Sciences, Bayero University, Kano, Nigeria.
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Malaysia.
Int Immunopharmacol. 2022 Oct;111:109130. doi: 10.1016/j.intimp.2022.109130. Epub 2022 Aug 12.
Several studies have shown that interleukin 6 (IL-6) is a multifunctional cytokine with both pro-inflammatory and anti-inflammatory activity, depending on the immune response context. Macrophages are among several cells that secrete IL-6, which they express upon activation by antigens, subsequently inducing fever and production of acute-phase proteins from the liver. Moreover, IL-6 induces the final maturation of B cells into memory B cells and plasma cells as well as an adaptive role for short-term energy allocation. Activation of IL-6 receptors results in the intracellular activation of the JAK/STAT pathway with resultant production of inflammatory cytokines. Several mechanisms-controlled IL-6 expression, but aberrant production was shown to be crucial in the pathogenesis of many diseases, which include autoimmune and chronic inflammatory diseases. IL-6 in combination with transforming growth factor β (TGF-β) induced differentiation of naïve T cells to Th17 cells, which is the cornerstone in autoimmune diseases. Recently, IL-6 secretion was shown to form the backbone of hypercytokinemia seen in the Coronavirus disease 2019 (COVID-19)-associated hyperinflammation and multiorgan failure. There are two classes of approved IL-6 inhibitors: anti-IL-6 receptor monoclonal antibodies (e.g., tocilizumab) and anti-IL-6 monoclonal antibodies (i.e., siltuximab). These drugs have been evaluated in patients with rheumatoid arthritis, juvenile idiopathic arthritis, cytokine release syndrome, and COVID-19 who have systemic inflammation. JAK/STAT pathway blockers were also successfully used in dampening IL-6 signal transduction. A better understanding of different mechanisms that modulate IL-6 expression will provide the much-needed solution with excellent safety and efficacy profiles for the treatment of autoimmune and inflammatory diseases in which IL-6 derives their pathogenesis.
已有多项研究表明,白细胞介素 6(IL-6)是一种多功能细胞因子,具有促炎和抗炎活性,具体取决于免疫反应的背景。几种细胞会分泌白细胞介素 6,其中包括抗原激活的巨噬细胞,这会诱导发热和肝脏产生急性期蛋白。此外,白细胞介素 6 诱导 B 细胞最终成熟为记忆 B 细胞和浆细胞,并在短期能量分配中发挥适应性作用。白细胞介素 6 受体的激活导致 JAK/STAT 途径的细胞内激活,从而产生炎症细胞因子。有几种机制可以控制白细胞介素 6 的表达,但异常产生被证明在许多疾病的发病机制中至关重要,其中包括自身免疫性疾病和慢性炎症性疾病。白细胞介素 6 与转化生长因子-β(TGF-β)结合可诱导初始 T 细胞分化为 Th17 细胞,这是自身免疫性疾病的基石。最近,白细胞介素 6 的分泌被证明是 2019 年冠状病毒病(COVID-19)相关过度炎症和多器官衰竭中所见细胞因子过度血症的基础。有两类已批准的白细胞介素 6 抑制剂:抗白细胞介素 6 受体单克隆抗体(例如,托珠单抗)和抗白细胞介素 6 单克隆抗体(即西妥昔单抗)。这些药物已在患有类风湿关节炎、幼年特发性关节炎、细胞因子释放综合征和 COVID-19 的全身炎症患者中进行了评估。JAK/STAT 途径阻滞剂也成功地用于抑制白细胞介素 6 信号转导。更好地了解调节白细胞介素 6 表达的不同机制将为治疗自身免疫性和炎症性疾病提供急需的解决方案,这些疾病的发病机制与白细胞介素 6 有关,并且具有出色的安全性和疗效。