Interleukin 6

Any Other Information

1. What is IL6?

Interleukin 6 (IL-6) is an interleukin that acts as both a pro-inflammatory cytokine and an anti-inflammatory myokine. It is encoded by the IL6 gene.

2. What is the preferred vacutainer for the sample collection?

Sample collected in gel tube is preferred. Sample collected in red plain tube, non SST can give excessively high results.

3. What is the method/instrument used for measuring IL6?

ECLIA electrochemiluminescence immunoassay analyzer. 

4. What is the reference range for IL6 & Report Interpretation?

The reference range for IL6 is 0-7 pg/ml. IL - 6-Interleukin-6 (IL-6) is an early marker for inflammation in sepsis.IL-6 levels predict development of septic complication. IL-6 levels predict severity of sepsis. IL-6 levels are associated with patient outcome & organ dysfunction. It is a marker for systemic inflammation, high IL-6 levels may be predictive of future organ dysfunction.

In addition, continually elevated IL-6 levels have been reported to be predictive of mortality in patients with sepsis. Normal levels do not exclude the possibility of an ongoing inflammatory process.

5. What are the factors of Limitations / Interference for the test?

Sample should not be taken from patients receiving therapy with high biotin doses (> 5mg/day) until at least 8 hours following the last biotin administration. No interference was observed from rheumatoid factors upto a concentration of 1500 IU/ml.

6. Can the report be released without a clinical correlation?

 The results should always be assessed in conjunction with the patient’s medical history, clinical examination and other findings.

7. What is the function of IL6?

Interleukin-6 (IL-6) is a multifunctional cytokine. It plays a central role in host defense due to its wide range of immune and hematopoietic activities and its potent ability to induce the acute phase response.

8. What does IL-6 do in inflammation?

IL-6 has a role in inflammation, immunity, and disease. IL-6 is a cytokine featuring pleiotropic activity; it induces synthesis of acute phase proteins such as CRP, serum amyloid A, fibrinogen, and hepcidin in hepatocytes, and it inhibits production of albumin.

9. In which conditions overexpression of IL6 found?

Overexpression of IL-6 has been implicated in the pathology of a number of diseases including multiple myeloma, rheumatoid arthritis, Castleman's disease, psoriasis, and post-menopausal osteoporosis.

10. How does IL6 reduce serum iron levels?

 IL-6 induces production of hepcidin, which blocks the action of iron transporter ferroportin 1 on gut and, thus, reduces serum iron levels. This means that the IL-6-hepcidin axis is responsible for hypoferremia and anemia which is associated with chronic inflammation.

11. What is the role of IL6 in immune response?

 IL-6 promotes specific differentiation of naïve CD4+ T cells, thereby performing an important function in the linking of innate to acquired immune response. It has been shown that IL-6, in combination with transforming growth factor (TGF)-β, is indispensable for Th17 differentiation from naïve CD4+ T cells, but it is seen that IL-6 also inhibits TGF-β-induced Treg differentiation. Up-regulation of the Th17/Treg balance is considered to be responsible for the disruption of immunological tolerance, and is thus pathologically involved in the development of autoimmune diseases and chronic inflammatory diseases. It has been further shown that IL-6 also promotes T-follicular helper-cell differentiation as well as production of IL-21, which regulates immunoglobulin (Ig) synthesis and IgG4 production in particular. IL-6 also induces the differentiation of CD8+ T cells into cytotoxic T cells . Under one of its previous names, BSF-2, IL-6 was found to be able to induce the differentiation of activated B cells into Ab-producing plasma cells, so that continuous oversynthesis of IL-6 results in hypergammaglobulinemia and autoantibody production.

12. What are the biological effects of IL6?

When IL-6 is generated in bone marrow stromal cells, it stimulates the RANKL, which is responsible for the differentiation and activation of osteoclasts and this leads to bone resorption and osteoporosis. IL-6 also induces excess production of VEGF, which leads to enhanced angiogenesis and increased vascular permeability, which are pathological features of inflammatory lesions and are seen in, for example, synovial tissues of rheumatoid arthritis (RA) or edema of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Also, it has been reported that IL-6 aids keratinocyte proliferation or the generation of collagen in dermal fibroblasts that may account for changes in the skin of patients with systemic sclerosis.

    13. Which factors are involved in the regulation of IL6 synthesis?

In addition to immune-mediated cells, mesenchymal cells, endothelial cells, fibroblasts, and many other cells are also involved in the production of IL-6 in response to various stimuli. IL-6 issues a warning signal to indicate occurrence of an emergency this accounts for the strict regulation of IL-6 synthesis both gene transcriptionally and post-transcriptionally. A number of transcription factors have been shown to regulate the IL-6 gene transcription. The functional cis-regulatory elements in the human IL-6 gene 5′ flanking region are found binding sites for NF-κB, specificity protein 1 (SP1), nuclear factor IL-6 (NF-IL-6) (also known as CAAT/enhancer-binding protein β), activator protein 1 (AP-1), and interferon regulatory factor 1. Activation of cis-regulatory elements by stimulation with IL-1, TNF, TLR-mediated signal, and forskolin lead to activation of the IL-6 promoter.

14. Role of IL6 in Covid 19?

IL-6 is an important cytokine with pleiotropic functions such as metabolic regulation to inflammation, auto-immunity and acute-phase response.COVID-19 patients are found to have high levels of IL-6 and are associated with pulmonary inflammation and extensive lung damage.COVID-19 infection has an aggressive inflammatory response with a large amount of pro-inflammatory cytokines, known as the ‘cytokine storm’. Acute increase in circulating levels of pro-inflammatory cytokines including IL-6, IL-1, TNF-α and interferon is the reason for the cytokine storm.IL-6 may be a therapeutic target for inhibiting the cytokine storm and cytokine storm-associated organ damage.

15. Which drug blocks the function of IL6?.

 Tocilizumab blocks IL-6 function by binding to IL-6 receptor.

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