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any of several lymphokines that promote macrophages and killer T cells and B cells and other components of the immune system

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/09 22:54:29」(JST)

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Interleukin 6 (IL-6) is an interleukin that acts as both a pro-inflammatory cytokine and an anti-inflammatory myokine. In humans, it is encoded by the IL6 gene.^[1]

IL-6 is secreted by T cells and macrophages to stimulate immune response, e.g. during infection and after trauma, especially burns or other tissue damage leading to inflammation. IL-6 also plays a role in fighting infection, as IL-6 has been shown in mice to be required for resistance against bacterium Streptococcus pneumoniae.^[2]

In addition, osteoblasts secrete IL-6 to stimulate osteoclast formation. Smooth muscle cells in the tunica media of many blood vessels also produce IL-6 as a pro-inflammatory cytokine. IL-6's role as an anti-inflammatory cytokine is mediated through its inhibitory effects on TNF-alpha and IL-1, and activation of IL-1ra and IL-10.

1 Function
2 Role as myokine
3 Receptor
4 Interactions
5 Role in disease
- 5.1 Rheumatoid arthritis
- 5.2 Cancer
- 5.3 Infectious diseases
  - 5.3.1 Enterovirus 71
- 5.4 Epigenetic modifications
  - 5.4.1 Schizophrenia
  - 5.4.2 Depression and major depressive disorder
6 References
7 Further reading
8 External links

Function

IL-6 is an important mediator of fever and of the acute phase response. It is capable of crossing the blood-brain barrier^[3] and initiating synthesis of PGE₂ in the hypothalamus, thereby changing the body's temperature setpoint. In muscle and fatty tissue, IL-6 stimulates energy mobilization that leads to increased body temperature. IL-6 can be secreted by macrophages in response to specific microbial molecules, referred to as pathogen-associated molecular patterns (PAMPs). These PAMPs bind to an important group of detection molecules of the innate immune system, called pattern recognition receptors (PRRs), including Toll-like receptors (TLRs). These are present on the cell surface and intracellular compartments and induce intracellular signaling cascades that give rise to inflammatory cytokine production.

IL-6 is also essential for hybridoma growth and is found in many supplemental cloning media such as briclone. Inhibitors of IL-6 (including estrogen) are used to treat postmenopausal osteoporosis. IL-6 is also produced by adipocytes and is thought to be a reason why obese individuals have higher endogeneous levels of CRP.^[4] Intranasally administered IL-6 has been shown to improve sleep-associated consolidation of emotional memories.^[5]

IL-6 is responsible for stimulating acute phase protein synthesis, as well as the production of neutrophils in the bone marrow. It supports the growth of B cells and is antagonistic to regulatory T cells.

Role as myokine

IL-6 is also considered a myokine, a cytokine produced from muscle, which is elevated in response to muscle contraction.^[6] It is significantly elevated with exercise, and precedes the appearance of other cytokines in the circulation. During exercise, it is thought to act in a hormone-like manner to mobilize extracellular substrates and/or augment substrate delivery.^[7]

IL-6 has extensive anti-inflammatory functions in its role as a myokine. IL-6 was the first myokine that was found to be secreted into the blood stream in response to muscle contractions.^[8] Aerobic exercise provokes a systemic cytokine response, including, for example, IL-6, IL-1 receptor antagonist (IL-1ra), and IL-10. IL-6 was serendipitously discovered as a myokine because of the observation that it increased in an exponential fashion proportional to the length of exercise and the amount of muscle mass engaged in the exercise. It has been consistently demonstrated that the plasma concentration of IL-6 increases during muscular exercise. This increase is followed by the appearance of IL-1ra and the anti-inflammatory cytokine IL-10. In general, the cytokine response to exercise and sepsis differs with regard to TNF-α. Thus, the cytokine response to exercise is not preceded by an increase in plasma-TNF-α. Following exercise, the basal plasma IL-6 concentration may increase up to 100-fold, but less dramatic increases are more frequent. The exercise-induced increase of plasma IL-6 occurs in an exponential manner and the peak IL-6 level is reached at the end of the exercise or shortly thereafter. It is the combination of mode, intensity, and duration of the exercise that determines the magnitude of the exercise-induced increase of plasma IL-6.^[9]

IL-6 had previously been classified as a proinflammatory cytokine. Therefore, it was first thought that the exercise-induced IL-6 response was related to muscle damage.^[10] However, it has become evident that eccentric exercise is not associated with a larger increase in plasma IL-6 than exercise involving concentric "nondamaging" muscle contractions. This finding clearly demonstrates that muscle damage is not required to provoke an increase in plasma IL-6 during exercise. As a matter of fact, eccentric exercise may result in a delayed peak and a much slower decrease of plasma IL-6 during recovery.^[11]

Recent work has shown that both upstream and downstream signalling pathways for IL-6 differ markedly between myocytes and macrophages. It appears that unlike IL-6 signalling in macrophages, which is dependent upon activation of the NFκB signalling pathway, intramuscular IL-6 expression is regulated by a network of signalling cascades, including the Ca2+/NFAT and glycogen/p38 MAPK pathways. Thus, when IL-6 is signalling in monocytes or macrophages, it creates a pro-inflammatory response, whereas IL-6 activation and signalling in muscle is totally independent of a preceding TNF-response or NFκB activation, and is anti-inflammatory.^[12]

IL-6, among an increasing number of other recently identified myokines, thus remains an important topic in myokine research. It appears in muscle tissue and in the circulation during exercise at levels up to one hundred times basal rates, as noted, and is seen as having a beneficial impact on health and bodily functioning when elevated in response to physical exercise.^[13] IL-6 was the first myokine that was found to be secreted into the blood stream in response to muscle contractions.^[14]

Receptor

IL-6 signals through a cell-surface type I cytokine receptor complex consisting of the ligand-binding IL-6Rα chain (CD126), and the signal-transducing component gp130 (also called CD130). CD130 is the common signal transducer for several cytokines including leukemia inhibitory factor (LIF), ciliary neurotropic factor, oncostatin M, IL-11 and cardiotrophin-1, and is almost ubiquitously expressed in most tissues. In contrast, the expression of CD126 is restricted to certain tissues. As IL-6 interacts with its receptor, it triggers the gp130 and IL-6R proteins to form a complex, thus activating the receptor. These complexes bring together the intracellular regions of gp130 to initiate a signal transduction cascade through certain transcription factors, Janus kinases (JAKs) and Signal Transducers and Activators of Transcription (STATs).^[15]

IL-6 is probably the best-studied of the cytokines that use gp130, also known as IL-6 signal transducer (IL6ST), in their signalling complexes. Other cytokines that signal through receptors containing gp130 are Interleukin 11 (IL-11), Interleukin 27 (IL-27), ciliary neurotrophic factor (CNTF), cardiotrophin-1 (CT-1), cardiotrophin-like cytokine (CLC), leukemia inhibitory factor (LIF), oncostatin M (OSM), Kaposi's sarcoma-associated herpesvirus interleukin 6-like protein (KSHV-IL6).^[16] These cytokines are commonly referred to as the IL-6 like or gp130 utilising cytokines ^[17]

In addition to the membrane-bound receptor, a soluble form of IL-6R (sIL-6R) has been purified from human serum and urine. Many neuronal cells are unresponsive to stimulation by IL-6 alone, but differentiation and survival of neuronal cells can be mediated through the action of sIL-6R. The sIL-6R/IL-6 complex can stimulate neurites outgrowth and promote survival of neurons and, hence, may be important in nerve regeneration through remyelination.

Interactions

Interleukin 6 has been shown to interact with interleukin-6 receptor.^[18]^[19]^[20] and glycoprotein 130.^[21]

There is considerable functional overlap and interaction between Substance P (SP), the natural ligand for the neurokinin type 1 receptor (NK1R, a mediator of immunomodulatory activity) and IL-6.

Role in disease

IL-6 stimulates the inflammatory and auto-immune processes in many diseases such as diabetes,^[22] atherosclerosis,^[23] depression,^[24] Alzheimer's Disease,^[25] systemic lupus erythematosus,^[26] multiple myeloma,^[27] prostate cancer,^[28] Behçet's disease,^[29] and rheumatoid arthritis.^[30]

Hence, there is an interest in developing anti-IL-6 agents as therapy against many of these diseases.^[31]^[32] The first such is tocilizumab, which has been approved for rheumatoid arthritis,^[33] Castleman's disease^[34] and systemic juvenile idiopathic arthritis.^[35] Others are in clinical trials.^[36]

Rheumatoid arthritis

The first FDA approved anti-IL-6 was for RA.

Cancer

Recently, Anestakis et al. outlined the interleukin mechanisms in cancer progression and possibilities in application for cancer immunotherapy in their systematic review.^[37] IL-6 was seen to have roles in tumor microenvironment regulation,^[38] production of breast cancer stem cell-like cells,^[39] metastasis through down-regulation of E-cadherin,^[40] and alteration of DNA methylation in oral cancer.^[41]

Advanced/metastatic cancer patients have higher levels of IL-6 in their blood.^[42] One example of this is pancreatic cancer, with noted elevation of IL-6 present in patients correlating with poor survival rates.^[43]

Infectious diseases

Enterovirus 71

High IL-6 levels are associated with the development of encephalitis in children and immunodeficient mouse models infected with Enterovirus 71; this highly contagious virus normally causes a milder illness called Hand, foot, and mouth disease but can cause life-threatening encephalitis in some cases. EV71 patients with a certain gene polymorphism in IL-6 also appear to be more susceptible to developing encephalitis.

Epigenetic modifications

IL-6 has been shown to lead to several neurological diseases through its impact on epigenetic modification within the brain.^[44]^[45] IL-6 activates the Phosphoinositide 3-kinase (PI3K) pathway, and a downstream target of this pathway is the protein kinase B (PKB) (Hodge et al., 2007). IL-6 activated PKB can phosphorylate the nuclear localization signal on DNA methyltransferase-1(DNMT1).^[46] This phosphorylation causes movement of DNMT1 to the nucleus, where it can be transcribed.^[46] DNMT1 recruits other DNMTs, including DNMT3A and DNMT3B, which, as a complex, recruit HDAC1.^[45] This complex adds methyl groups to CpG islands on gene promoters, repressing the chromatin structure surrounding the DNA sequence and inhibiting transcriptional machinery from accessing the gene to induce transcription.^[45] Increased IL-6, therefore, can hypermethylate DNA sequences and subsequently decrease gene expression through its effects on DNMT1 expression.^[47]

Schizophrenia

The induction of epigenetic modification by IL-6 has been proposed as a mechanism in the pathology of schizophrenia through the hypermethylation and repression of the GAD67 promoter.^[45] This hypermethylation may potentially lead to the decreased GAD67 levels seen in the brains of people with schizophrenia.^[48] GAD67 may be involved in the pathology of schizophrenia through its effect on GABA levels and on neural oscillations.^[49] Neural oscillations occur when inhibitory GABAergic neurons fire synchronously and cause inhibition of a multitude of target excitatory neurons at the same time, leading to a cycle of inhibition and disinhibition.^[49] These neural oscillations are impaired in schizophrenia, and these alterations may be responsible for both positive and negative symptoms of schizophrenia.^[50]

Depression and major depressive disorder

The epigenetic effects IL-6 have also been implicated in the pathology of depression. The effects of IL-6 on depression are mediated through the repression of brain-derived neurotrophic factor (BDNF) expression in the brain; DNMT1 hypermethylates the BDNF promoter and reduces BDNF levels.^[51] Altered BDNF function has been implicated in depression,^[52] which is likely due to epigenetic modification following IL-6 upregulation.^[51] BDNF is a neutrophic factor implicated in spine formation, density, and morphology on neurons.^[53] Downregulation of BDNF, therefore, may cause decreased connectivity in the brain. Depression is marked by altered connectivity, in particular between the anterior cingulate cortex and several other limbic areas, such as the hippocampus.^[54] The anterior cingulate cortex is responsible for detecting incongruences between expectation and perceived experience.^[55] Altered connectivity of the anterior cingulate cortex in depression, therefore, may cause altered emotions following certain experiences, leading to depressive reactions.^[55] This altered connectivity is mediated by IL-6 and its effect on epigenetic regulation of BDNF.^[51]

Additional preclinical and clinical data, suggest that Substance P [SP] and IL-6 may act in concert to promote major depression. SP, a hybrid neurotransmitter-cytokine, is co-transmitted with BDNF through paleo-spinothalamic circuitry from the periphery with collaterals into key areas of the limbic system. However, both IL6 and SP mitigate expression of BDNF in brain regions associated with negative affect and memory. SP and IL6 both relax tight junctions of the blood brain barrier, such that effects seen in fMRI experiments with these molecules may be a bidirectional mix of neuronal, glial, capillary, synaptic, paracrine, or endocrine-like effects. At the cellular level, SP is noted to increase expression of interleukin-6 (IL-6) through PI-3K, p42/44 and p38 MAP kinase pathways. Data suggest that nuclear translocation of NF-κB regulates IL-6 overexpression in SP-stimulated cells.^[56] This is of key interest as: 1) a meta-analysis indicates an association of major depressive disorder, C-reactive protein and IL6 plasma concentrations,^[57] 2) NK1R antagonists [five molecules] studied by 3 independent groups groups in over 2000 patients from 1998-2013 validate the mechanism as dose-related, fully effective antidepressant, with a unique safety profile.^[58]^[59] (see Summary of NK1RAs in Major Depression), 3) the preliminary observation that plasma concentrations of IL6 are elevated in depressed patients with cancer,^[60] and 4) selective NK1RAs may eliminate endogenous SP stress-induced augmentation of IL-6 secretion pre-clinically.^[61] These and many other reports suggest that a clinical study of a neutralizing IL-6 biological or drug based antagonist is likely warranted in patients with major depressive disorder, with or without co-morbid chronic inflammatory based illnesses; that the combination of NK1RAs and IL6 blockers may represent a new, potentially biomarkable approach to major depression, and possibly bipolar disorder.

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External links

IL-6 expression in various cancers

UpToDate Contents

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1. IL-1、IL-6、およびRANKLを抑制する生物学的製剤の関節リウマチにおけるランダム化臨床試験 randomized clinical trials in rheumatoid arthritis of biologic agents that inhibit il 1 il 6 and rankl
2. 急性期反応物質 acute phase reactants
3. リウマチ性疾患における生物学的製剤の概要 overview of biologic agents in the rheumatic diseases
4. 心血管疾患と同等のリスクと確立した危険因子の概要 overview of the risk equivalents and established risk factors for cardiovascular disease
5. 多中心性キャッスルマン病 multicentric castlemans disease

English Journal

Pregnane x receptor modulates the inflammatory response in primary cultures of hepatocytes.

Sun M1, Cui W1, Woody SK1, Staudinger JL2.
Drug metabolism and disposition: the biological fate of chemicals.Drug Metab Dispos.2015 Mar;43(3):335-43. doi: 10.1124/dmd.114.062307. Epub 2014 Dec 19.
Bacterial sepsis is characterized by a rapid increase in the expression of inflammatory mediators to initiate the acute phase response in liver. Inflammatory mediator release is counterbalanced by the coordinated expression of anti-inflammatory molecules such as interleukin 1 receptor antagonist (IL
PMID 25527709

Inhibition of IL-6/STAT3 axis and targeting Axl and Tyro3 receptor tyrosine kinases by apigenin circumvent taxol resistance in ovarian cancer cells.

Suh YA1, Jo SY1, Lee HY2, Lee C2.
International journal of oncology.Int J Oncol.2015 Mar;46(3):1405-11. doi: 10.3892/ijo.2014.2808. Epub 2014 Dec 23.
Ovarian cancer is the number one cause of death from gynaecological malignancy. Platinum-based and taxol-based chemotherapy has been used as a standard therapy, but intrinsic and acquired resistance to chemotherapy is a major obstacle to treat the disease. In the present study, we found that in the
PMID 25544427

Association of inflammatory biomarkers with depressive symptoms and cognitive decline in a community-dwelling healthy older sample: A 3-year follow-up study.

Matsushima J1, Kawashima T2, Nabeta H2, Imamura Y3, Watanabe I4, Mizoguchi Y2, Kojima N5, Yamada S6, Monji A7.
Journal of affective disorders.J Affect Disord.2015 Mar 1;173:9-14. doi: 10.1016/j.jad.2014.10.030. Epub 2014 Oct 22.
BACKGROUND: The relationship between the pathophysiology of dementia and neuroinflammation is well-known. The number of reports stating that depression is a risk factor for dementia has recently been increasing. These epidemiological findings suggest the possibility that both depression and dementia
PMID 25462389

Japanese Journal

Reversible Cognitive Dysfunction in Elderly-onset Systemic Lupus Erythematosus, Successfully Treated with Aggressive Immunosuppressive Therapy

Internal Medicine 57(20), 3025-3028, 2018-10-15
NAID 120006534556

重度歯周炎患者の血中サイトカインと歯周組織検査値との関係

岐阜歯科学会雑誌 = The Journal of Gifu Dental Society 45(2), 123-128, 2018-10
NAID 120006538893

Synovial GATA1 mediates rheumatoid arthritis progression via transcriptional activation of NOS2 signaling

Microbiology and immunology 62(9), 594-606, 2018-09
NAID 40021669889

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★リンクテーブル★

リンク元	「IL-6」
拡張検索	「interleukin-6 receptor」「interleukin-6 receptor alpha subunit」
関連記事	「interleukin」「interleukins」

「IL-6」

Interleukin 6
	PDB rendering based on 1ALU.
Available structures
PDB	Ortholog search: PDBe, RCSB
List of PDB id codes
	1ALU, 1IL6, 1N2Q, 1P9M, 2IL6, 4CNI, 4J4L, 4NI7, 4NI9, 4O9H
Identifiers
Symbols	IL6 ; BSF2; HGF; HSF; IFNB2; IL-6
External IDs	OMIM: 147620 MGI: 96559 HomoloGene: 502 ChEMBL: 1795129 GeneCards: IL6 Gene
Gene ontology
Molecular function	• cytokine activity; • interleukin-6 receptor binding; • protein binding; • growth factor activity;
Cellular component	• extracellular region; • extracellular space; • cytoplasm; • interleukin-6 receptor complex; • external side of plasma membrane;
Biological process	• neutrophil apoptotic process; • response to yeast; • hepatic immune response; • neutrophil mediated immunity; • monocyte chemotaxis; • positive regulation of acute inflammatory response; • positive regulation of leukocyte chemotaxis; • negative regulation of protein kinase activity; • acute-phase response; • inflammatory response; • humoral immune response; • aging; • positive regulation of cell proliferation; • negative regulation of cell proliferation; • regulation of cell shape; • response to heat; • response to cold; • regulation of vascular endothelial growth factor production; • negative regulation of lipid storage; • response to auditory stimulus; • cell growth; • cytokine-mediated signaling pathway; • platelet activation; • response to caffeine; • endocrine pancreas development; • neuron projection development; • response to nutrient levels; • response to peptidoglycan; • positive regulation of chemokine production; • positive regulation of interleukin-6 production; • response to insulin; • negative regulation of collagen biosynthetic process; • positive regulation of peptidyl-serine phosphorylation; • positive regulation of protein import into nucleus, translocation; • positive regulation of T cell proliferation; • response to drug; • positive regulation of tyrosine phosphorylation of Stat3 protein; • glucose homeostasis; • defense response to protozoan; • positive regulation of apoptotic process; • negative regulation of apoptotic process; • negative regulation of cysteine-type endopeptidase activity involved in apoptotic process; • response to amino acid; • positive regulation of MAPK cascade; • negative regulation of chemokine biosynthetic process; • regulation of circadian sleep/wake cycle, non-REM sleep; • positive regulation of nitric oxide biosynthetic process; • cell redox homeostasis; • negative regulation of fat cell differentiation; • positive regulation of T-helper 2 cell differentiation; • positive regulation of neuron differentiation; • positive regulation of osteoblast differentiation; • negative regulation of gluconeogenesis; • positive regulation of translation; • positive regulation of DNA replication; • regulation of angiogenesis; • positive regulation of transcription, DNA-templated; • positive regulation of transcription from RNA polymerase II promoter; • positive regulation of JAK-STAT cascade; • response to antibiotic; • muscle cell cellular homeostasis; • bone remodeling; • negative regulation of hormone secretion; • negative regulation of muscle organ development; • positive regulation of smooth muscle cell proliferation; • positive regulation of epithelial cell proliferation; • negative regulation of cytokine secretion; • positive regulation of peptidyl-tyrosine phosphorylation; • defense response to Gram-negative bacterium; • defense response to Gram-positive bacterium; • positive regulation of B cell activation; • positive regulation of immunoglobulin secretion; • positive regulation of sequence-specific DNA binding transcription factor activity; • positive regulation of NF-kappaB transcription factor activity; • response to glucocorticoid; • response to calcium ion; • response to electrical stimulus; • defense response to virus; • positive regulation of protein kinase B signaling; • positive regulation of transmission of nerve impulse; • branching involved in salivary gland morphogenesis; • epithelial cell proliferation involved in salivary gland morphogenesis; • glucagon secretion; • interleukin-6-mediated signaling pathway; • cellular response to hydrogen peroxide; • positive regulation of ERK1 and ERK2 cascade; • cellular response to lipopolysaccharide; • cellular response to interleukin-1; • cellular response to interleukin-6; • cellular response to tumor necrosis factor; • cellular response to dexamethasone stimulus; • T-helper 17 cell lineage commitment; • negative regulation of neuron death; • positive regulation of STAT protein import into nucleus; • positive regulation of type B pancreatic cell apoptotic process;
	Sources: Amigo / QuickGO
RNA expression pattern
	More reference expression data
Orthologs
	v; t; e;

　　[★]

英: interleukin-6
同: B細胞刺激因子2 B cell stimulating factor 2 BSF-2
関: サイトカイン

炎症性サイトカイン

産生細胞

T細胞、マクロファージ、内皮細胞

機能

T細胞とB細胞の増殖と分化、急性期タンパクの産生、発熱

液性免疫に関わる。

IL-6の多彩な機能

肝細胞	APP産生
腎メサンギウム細胞	増殖
神経細胞	分化
NK細胞	活性化
骨髄腫細胞	増殖
B細胞	抗体産生
T細胞	キラーT細胞、IL-2産生
巨核球	血小板増多
造骨系幹細胞	分化

受容体

CD126, CD130

臨床関連

IL-6は関節リウマチの悪化や多発性骨髄腫の増殖促進に関与している

「interleukin-6 receptor」

　　[★]

インターロイキン6受容体、インターロイキン6レセプター

関: IL-6 receptor、IL6 receptor

「interleukin-6 receptor alpha subunit」

　　[★]

インターロイキン6受容体αサブユニット

「interleukin」

　　[★] インターロイキン IL 　

「interleukins」