Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China.
Curr Neurovasc Res. 2024;21(3):292-299. doi: 10.2174/0115672026323216240722194958.
Interleukin-6 (IL-6) plays an important role in the pathophysiology of atherosclerosis. This study aimed to determine whether IL-6 is a crucial biomarker associated with Multiple Acute Infarctions (MAIs), which indicate an important stroke mechanism of artery-to-artery embolism with a high risk of stroke recurrence in symptomatic Intracranial Atherosclerotic Disease (sICAD). We tested the association between circulating IL-6 levels and the presence of MAIs in a prospective population-based registry.
We included 1,919 patients with sICAD and baseline IL-6 levels from the Third China National Stroke Registry for the current analysis, The baseline IL-6 was centrally measured at Beijing Tiantan Hospital, Images of the brain parenchyma and vascular structures were digitized and then blindly and independently read by two groups of trained readers, The recruited patients were divided into 3 groups according to IL-6 tertiles, The relationship between baseline IL-6 tertile levels and the presence of MAIs was modeled using multivariate logistic regression.
Compared to patients in the first IL-6 tertile those in the second and third tertiles demonstrated a significantly higher proportion of MAIs. The odds ratios were 1.81 [95% Confidence Interval (CI), 1.42-2.30] for the second versus first tertile and 2.15 (95% CI 1.66-2.79) for the third versus first tertile, The proportion of patients with MAIs increased with rising IL-6 tertiles observed at 59.3%, 71.6% and 76.4% for the first, second and third tertiles, respectively (P for trend < 0.001). The association between higher IL-6 tertiles and increased proportion of MAIs was also present in subgroups defined by age < 65 years, age ≥ 65 years, male, and high-sensitivity C-reactive Protein (hs-CRP) ≥ 2 mg/L. Furthermore, a significant interaction was detected for the hs- CRP subgroup (P = 0.038). In sensitivity analyses, the positive correlation between IL-6 levels and the proportion of MAIs remained consistent.
In patients with sICAD, higher IL-6 levels were associated with an increased proportion of MAIs. IL-6 could be used as a biomarker and a potential therapeutic target for future atherosclerosis treatment and prevention in patients with sICAD.
白细胞介素 6（IL-6）在动脉粥样硬化的病理生理学中起着重要作用。本研究旨在确定 IL-6 是否是与多发性急性梗死（MAIs）相关的关键生物标志物，MAIs 是症状性颅内动脉粥样硬化疾病（sICAD）中动脉到动脉栓塞的重要中风机制，并伴有中风复发的高风险。我们在一个前瞻性的基于人群的登记处测试了循环 IL-6 水平与 MAIs 之间的关联。
我们从第三次中国国家中风登记处纳入了 1919 名患有 sICAD 和基线 IL-6 水平的患者，目前的分析结果，基线 IL-6 在北京天坛医院进行了中心测量，脑实质和血管结构的图像进行了数字化处理，然后由两组经过培训的读者进行盲法和独立阅读，根据 IL-6 三分位组将入组患者分为 3 组，使用多变量逻辑回归模型来模拟基线 IL-6 三分位水平与 MAIs 存在之间的关系。
与处于第一 IL-6 三分位的患者相比，处于第二和第三 IL-6 三分位的患者 MAIs 比例明显更高。第二三分位与第一三分位的比值比为 1.81（95%置信区间[CI]，1.42-2.30），第三三分位与第一三分位的比值比为 2.15（95%CI 1.66-2.79），观察到 MAIs 患者的比例随着 IL-6 三分位的升高而增加，分别为第一、第二和第三三分位的 59.3%、71.6%和 76.4%（P 趋势<0.001）。在根据年龄<65 岁、年龄≥65 岁、男性和高敏 C 反应蛋白（hs-CRP）≥2mg/L 定义的亚组中，较高的 IL-6 三分位与 MAIs 比例增加之间也存在关联。此外，hs-CRP 亚组中检测到显著的交互作用（P=0.038）。在敏感性分析中，IL-6 水平与 MAIs 比例之间的正相关性仍然一致。
在 sICAD 患者中，较高的 IL-6 水平与 MAIs 比例增加相关。IL-6 可以作为生物标志物和潜在的治疗靶点，用于未来 sICAD 患者的动脉粥样硬化治疗和预防。
