2021
DOI: 10.1016/s2213-2600(21)00103-x
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Interleukin-6: obstacles to targeting a complex cytokine in critical illness

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… Show more

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Cited by 164 publications
(111 citation statements)
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“…The functional impact of pleotropic cytokines, including IL-6, may not be reflected in the absolute level of the cytokine measured in serum ( 35 ). Further understanding of the impact of soluble mediators in the context of their diverse immune and nonimmune functions remains a challenge.…”
Section: Discussionmentioning
confidence: 99%
“…The functional impact of pleotropic cytokines, including IL-6, may not be reflected in the absolute level of the cytokine measured in serum ( 35 ). Further understanding of the impact of soluble mediators in the context of their diverse immune and nonimmune functions remains a challenge.…”
Section: Discussionmentioning
confidence: 99%
“…(2) cardiovascular system support (defined as receipt of vasopressors) or death by 28 days in patients not receiving cardiovascular system support at randomization; (3) secondary infections by 28 days (this is the most important safety outcome); (4) in-hospital mortality; (5) kidney replacement therapy (KRT) or death by 28 days in patients not receiving KRT at randomization (excluding patients with underlying dialysis dependence or ≥stage III chronic kidney disease); (6) discharged alive from the hospital by 28 days; (7) mortality by 90 days; (8) duration of IMV up to 28 days (in those receiving IMV at randomization, with duration coded as 28 days for patients who died); and ( 9) secondary infections by 90 days. Data on serious adverse events or serious adverse reactions (as defined in each trial) were collected; however, no meta-analysis was planned because diverse definitions were used by different trials.…”
Section: Outcomes and Comparisonsmentioning
confidence: 99%
“…In addition, inflammatory cytokines can potentially induce cardiac sympathetic hyperactivation via hypothalamus-mediated and peripheral pathways [ 52 ]. Specific cytokines, such as interleukin (IL)-6, derived from T cells and macrophages, have been implicated in the inflammatory response and will be further elaborated [ 53 , 54 ].…”
Section: Pathophysiology Of Covid-19-associated Cardiovascular Complicationsmentioning
confidence: 99%