Xu Rui, Gao YongJun
Chengdu Sixth People's Hospital, Chengdu City, Sichuan Province, China.
The Second Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province, China.
BMC Neurol. 2025 May 14;25(1):203. doi: 10.1186/s12883-025-04194-5.
IL-6 has garnered significant attention as a potential factor in AD pathogenesis. The association between peripheral immune cells and IL-6 is evident, yet how peripheral immune cells mediate IL-6's effects on AD remains enigmatic regarding the precise pathophysiological processes. To address these uncertainties, we employed genetic evidence to investigate their impact. Our current study explores further the intricate relationship between IL-6, peripheral immune cells, and AD by using extensive publicly available genetic data, aiming to provide novel insights into this critical area of medical research.
The relevant data regarding IL-6, 731 peripheral immune cells, and AD were screened and retrieved from the GWAS database. Subsequently, we predominantly utilized the IVW approach to carry out bi-directional MR analyses between IL-6, 731 peripheral immune cells, and AD. We utilized two-step, two-sample MR analyses to determine three key factors: (i) IL-6 exhibits associations with both AD and specific peripheral immune cells, respectively, and there is an absence of inverse causality. (ii) Specific peripheral immune cells exhibit associations with AD, and there is an absence of inverse causality. (iii) to identify which peripheral immune cells mediate the effects of IL-6 on AD. Then we employed the MVMR approach to verify whether the mediating relationships obtained from the two-step, two-sample MR analyses remained valid. Furthermore, we calculated their respective mediating effects, the combined mediating effects, and the proportions of their mediating effect shares. All of the aforementioned steps were utilized to verify the reliability of causality employing sensitivity analysis, heterogeneity analysis, and horizontal pleiotropy analysis.
Our findings indicate a significant correlation between increased IL-6 levels and a reduced risk of AD (P = 0.009, OR = 0.941, 95%CI = 0.899- 0.985), along with elevated levels of CD28 CD45RA CD8br AC (P = 0.007, OR = 1.159, 95%CI = 1.007- 1.333). Also indicates a significant correlation between increased CD28 CD45RA CD8br AC (P = 0.005, OR = 0.983, 95%CI = 0.971- 0.995) levels and a reduced risk of AD. Therefore, through MVMR analysis, the effect of IL-6 on AD increased from -0.061 to -0.046 (95% CI: -0.090, -0.002) after genetic adjustment for CD28 CD45RA CD8br AC.
Increased CD28 CD45RA CD8br AC levels appear to partially mediate the effect of IL-6 on reducing AD risk.
白细胞介素-6(IL-6)作为阿尔茨海默病(AD)发病机制中的一个潜在因素已受到广泛关注。外周免疫细胞与IL-6之间的关联是明显的,然而,关于外周免疫细胞如何介导IL-6对AD的影响,其确切的病理生理过程仍不清楚。为了解决这些不确定性,我们利用遗传学证据来研究它们的影响。我们目前的研究通过使用广泛的公开可用遗传数据,进一步探索IL-6、外周免疫细胞和AD之间的复杂关系,旨在为这一医学研究的关键领域提供新的见解。
从全基因组关联研究(GWAS)数据库中筛选并检索有关IL-6、731种外周免疫细胞和AD的相关数据。随后,我们主要采用逆方差加权(IVW)方法对IL-6、731种外周免疫细胞和AD之间进行双向孟德尔随机化(MR)分析。我们利用两步两样本MR分析来确定三个关键因素:(i)IL-6分别与AD和特定外周免疫细胞存在关联,且不存在反向因果关系。(ii)特定外周免疫细胞与AD存在关联,且不存在反向因果关系。(iii)确定哪些外周免疫细胞介导IL-6对AD的影响。然后我们采用多变量孟德尔随机化(MVMR)方法来验证从两步两样本MR分析中获得的中介关系是否仍然有效。此外,我们计算了它们各自的中介效应、联合中介效应以及它们中介效应份额的比例。上述所有步骤均用于通过敏感性分析、异质性分析和水平多效性分析来验证因果关系的可靠性。
我们的研究结果表明,IL-6水平升高与AD风险降低之间存在显著相关性(P = 0.009,优势比[OR]=0.941,95%置信区间[CI]=0.899 - 0.985),同时CD28 CD45RA CD8br AC水平升高(P = 0.007,OR = 1.159,95%CI = 1.007 - 1.333)。还表明CD28 CD45RA CD8br AC水平升高(P = 0.005,OR = 0.983,95%CI = 0.971 - 0.995)与AD风险降低之间存在显著相关性。因此,通过MVMR分析,在对CD28 CD45RA CD8br AC进行基因调整后,IL-6对AD的影响从-0.061增加到-0.046(95%CI:-0.090,-0.002)。
CD28 CD45RA CD8br AC水平升高似乎部分介导了IL-6对降低AD风险的影响。