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心源性休克中的白细胞介素-6

Interleukin-6 in Cardiogenic Shock.

作者信息

Fazzini Luca, Golino Michele, Moroni Francesco, Castrichini Matteo, Tersalvi Gregorio, Manca Paolo, Abbate Antonio

机构信息

Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States of America.

Department of Medical Sciences and Public Health, Clinical Cardiology Unit, University of Cagliari, Cagliari, Italy.

出版信息

Curr Cardiol Rep. 2025 Aug 30;27(1):129. doi: 10.1007/s11886-025-02273-0.

DOI:10.1007/s11886-025-02273-0
PMID:40884675
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12398471/
Abstract

PURPOSE OF REVIEW

Cardiogenic shock (CS) is one of the leading causes of mortality in patients with acute cardiac disease, and systemic inflammation plays a critical role in its pathophysiology. This review explores the role of interleukin-6 (IL-6) in CS, with a focus on its biological pathways, prognostic value, and potential as a therapeutic target, highlighting the importance of addressing inflammation in this context.

RECENT FINDINGS

Recent evidence highlights systemic inflammation implied in CS progression. Among the various cytokines involved, IL-6 is a major pro-inflammatory cytokine associated with organ dysfunction, and high mortality rates in acute myocardial infarction complicated by CS. Mechanistic studies exhibited an involvement of IL-6 since the first stages of CS onset, suggesting its role as both a biomarker and likely a mediator of CS.

SUMMARY

IL-6 emerges as a key inflammatory mediator in CS pathophysiology, serving as a prognostic biomarker and a potential therapeutic target. Future research should focus on further understanding the underlying mechanism linking acute inflammation and CS, patient phenotyping, and optimizing anti-inflammatory strategies investigating IL-6-targeted therapies to improve outcomes in this poor prognosis condition. Clinical trials of IL-6 blockade in cardiogenic shock are lacking.

摘要

综述目的

心源性休克(CS)是急性心脏疾病患者死亡的主要原因之一,全身炎症在其病理生理学中起关键作用。本综述探讨白细胞介素-6(IL-6)在CS中的作用,重点关注其生物学途径、预后价值以及作为治疗靶点的潜力,强调在这种情况下解决炎症问题的重要性。

最新发现

近期证据突显了全身炎症在CS进展中的作用。在涉及的各种细胞因子中,IL-6是一种与器官功能障碍以及急性心肌梗死合并CS时的高死亡率相关的主要促炎细胞因子。机制研究表明,自CS发病的最初阶段起IL-6就参与其中,提示其既是CS的生物标志物,也可能是CS的介质。

总结

IL-6成为CS病理生理学中的关键炎症介质,可作为预后生物标志物和潜在治疗靶点。未来研究应聚焦于进一步了解急性炎症与CS之间的潜在机制、患者表型分析以及优化抗炎策略,研究针对IL-6的疗法以改善这种预后不良情况的结局。目前缺乏关于心源性休克中IL-6阻断的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/12398471/c22bae0a0e46/11886_2025_2273_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/12398471/bbad5530767d/11886_2025_2273_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/12398471/c22bae0a0e46/11886_2025_2273_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/12398471/bbad5530767d/11886_2025_2273_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c35d/12398471/c22bae0a0e46/11886_2025_2273_Fig2_HTML.jpg

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J Am Coll Cardiol. 2025 Apr 29;85(16):1618-1641. doi: 10.1016/j.jacc.2025.02.018. Epub 2025 Mar 17.
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Phenotyping Refractory Cardiogenic Shock Patients Receiving Venous-Arterial Extracorporeal Membrane Oxygenation Using Machine Learning Algorithms.使用机器学习算法对接受静脉-动脉体外膜肺氧合的难治性心源性休克患者进行表型分析。
Rev Cardiovasc Med. 2024 Aug 22;25(8):303. doi: 10.31083/j.rcm2508303. eCollection 2024 Aug.
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Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock.微轴流泵与常规治疗在梗死相关性心源性休克中的比较。
N Engl J Med. 2024 Apr 18;390(15):1382-1393. doi: 10.1056/NEJMoa2312572. Epub 2024 Apr 7.
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N Engl J Med. 2023 Oct 5;389(14):1286-1297. doi: 10.1056/NEJMoa2307227. Epub 2023 Aug 26.
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