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Interleukin-6: obstacles to targeting a complex cytokine in critical illness.
McElvaney, Oliver J; Curley, Gerard F; Rose-John, Stefan; McElvaney, Noel G.
  • McElvaney OJ; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Beaumont Hospital, Dublin, Ireland.
  • Curley GF; Beaumont Hospital, Dublin, Ireland; Department of Anaesthesia and Critical Care, Royal College of Surgeons in Ireland, Dublin, Ireland.
  • Rose-John S; Biochemical Institute, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
  • McElvaney NG; Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; Beaumont Hospital, Dublin, Ireland. Electronic address: gmcelvaney@rcsi.ie.
Lancet Respir Med ; 9(6): 643-654, 2021 06.
Article in English | MEDLINE | ID: covidwho-1291133
ABSTRACT
Circulating concentrations of the pleiotropic cytokine interleukin-6 (IL-6) are known to be increased in pro-inflammatory critical care syndromes, such as sepsis and acute respiratory distress syndrome. Elevations in serum IL-6 concentrations in patients with severe COVID-19 have led to renewed interest in the cytokine as a therapeutic target. However, although the pro-inflammatory properties of IL-6 are widely known, the cytokine also has a series of important physiological and anti-inflammatory functions. An adequate understanding of the complex processes by which IL-6 signalling occurs is crucial for the correct interpretation of IL-6 concentrations in the blood or lung, the use of IL-6 as a critical care biomarker, or the design of effective anti-IL-6 strategies. Here, we outline the role of IL-6 in health and disease, explain the different types of IL-6 signalling and their contribution to the net biological effect of the cytokine, describe the approaches to IL-6 inhibition that are currently available, and discuss implications for the future use of treatments such as tocilizumab in the critical care setting.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Interleukin-6 / Antibodies, Monoclonal, Humanized / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: Lancet Respir Med Year: 2021 Document Type: Article Affiliation country: S2213-2600(21)00103-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Interleukin-6 / Antibodies, Monoclonal, Humanized / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: Lancet Respir Med Year: 2021 Document Type: Article Affiliation country: S2213-2600(21)00103-x