Interleukin 6: a message from the heart

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Abstract
Interleukin 6 (IL-6) has gradually and quietly moved into the spotlight as a local and circulating marker of coronary plaque inflammation. Familiar to rheumatologists, endocrinologists, oncologists, and immunologists, this versatile cytokine is found in large quantities in human atherosclerotic plaques,10typically in macrophage rich areas.8 Raised circulating concentrations are found in patients with unstable angina11 and in patients at risk of future cardiovascular events.12 It can be produced by many vascular cells including endothelial cells, smooth muscle cells, lymphocytes and macrophages13 and, being the principal regulator of CRP release from the liver, it plausibly accounts for the link between coronary events and raised circulating CRP concentrations. Interestingly, based on its pleiotropic in vitro behaviour, the net biological effect of IL-6 at the plaque may either be to upregulate or to pacify the inflammatory response,13 although the balance of opinion favours the former.

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