Ren Jingjing, Wang Xiao-Qi, Nakao Tetsushi, Libby Peter, Shi Guo-Ping
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115.
Cardiol Discov. 2023 Sep;3(3):166-182. doi: 10.1097/CD9.0000000000000096. Epub 2023 Jul 27.
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection can lead to a cytokine storm, unleashed in part by pyroptosis of virus-infected macrophages and monocytes. Interleukin-6 (IL-6) has emerged as a key participant in this ominous complication of COVID-19. IL-6 antagonists have improved outcomes in patients with COVID-19 in some, but not all, studies. IL-6 signaling involves at least 3 distinct pathways, including classic-signaling, trans-signaling, and trans-presentation depending on the localization of IL-6 receptor and its binding partner glycoprotein gp130. IL-6 has become a therapeutic target in COVID-19, cardiovascular diseases, and other inflammatory conditions. However, the efficacy of inhibition of IL-6 signaling in metabolic diseases, such as obesity and diabetes, may depend in part on cell type-dependent actions of IL-6 in controlling lipid metabolism, glucose uptake, and insulin sensitivity owing to complexities that remain to be elucidated. The present review sought to summarize and discuss the current understanding of how and whether targeting IL-6 signaling ameliorates outcomes following SARS-CoV-2 infection and associated clinical complications, focusing predominantly on metabolic and cardiovascular diseases.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染可导致细胞因子风暴,部分原因是病毒感染的巨噬细胞和单核细胞发生细胞焦亡。白细胞介素6(IL-6)已成为COVID-19这一严重并发症的关键参与者。在一些但并非所有研究中,IL-6拮抗剂改善了COVID-19患者的预后。IL-6信号传导至少涉及3条不同的途径,包括经典信号传导、转信号传导和反式呈递,这取决于IL-6受体及其结合伴侣糖蛋白gp130的定位。IL-6已成为COVID-19、心血管疾病和其他炎症性疾病的治疗靶点。然而,抑制IL-6信号传导在肥胖和糖尿病等代谢性疾病中的疗效可能部分取决于IL-6在控制脂质代谢、葡萄糖摄取和胰岛素敏感性方面的细胞类型依赖性作用,因为其中的复杂性仍有待阐明。本综述旨在总结和讨论目前对靶向IL-6信号传导如何以及是否能改善SARS-CoV-2感染及相关临床并发症后的预后的理解,主要关注代谢性疾病和心血管疾病。