Abstract
Aortic dissection (AD) has been recognized to be associated with an inflammatory process. Clinical observations demonstrated that patients with AD had an elevated interleukin (IL)-6 level in comparison to hypertensive or healthy controls. Adverse events such as acute lung injury, postimplantation syndrome, and death are associated with an elevated IL-6 level. Thus, circulating IL-6 could be a reliable biomarker for the diagnosis of AD and for the eveluation of the therapeutic outcomes and the prognosis of AD patients. Therapeutic interventions aiming at attenuating the inflammatory status by IL-6 neutralization could effectively decrease the IL-6 level and thus reverse the progression of the disorder of AD patient. Endovascular aortic repair can effectively control the inflammatory cytokines. Selective antegrade cerebral perfusion with deep hypothermic circulatory arrest during aortic arch replacement shows better neuroprotectve effect with an improved IL-6 level of the cerebrospinal fluid. These results facilitate the understanding of the etiology of AD and guide the directions for the treatment of acute AD in the future. More effective therapeutic agents developed based on the theories of IL-6 signaling involved in the mechasims of AD are anticipated.
Highlights
The interleukin (IL) family is a group of cytokines involved in the pathogenesis of inflammatory, allergic, infectious, immunodeficient, neoplastic, fibrotic, and hypoxic disorders[1,2]
In one (5.3%) of the reports, the study group involved both acute and subacute aortic dissection (AD) cases, but the authors did not indicate the patient number of different AD phases[21]
Guo et al.[7] tried to explain the associated acute lung injury (ALI) in AD patients. They proposed that the activation of inflammatory cells and the release of inflammatory mediators might occur in acute AD patients
Summary
The interleukin (IL) family is a group of cytokines involved in the pathogenesis of inflammatory, allergic, infectious, immunodeficient, neoplastic, fibrotic, and hypoxic disorders[1,2]. Of the cardiac surgical patients, those with aortic dissection (AD) showed particular inherent relationships to IL-6[3]. In patients receiving an aortic aneurysm/ dissection repair, that the circulating IL-6 levels differed between acute AD and hypertensive or healthy controls[3]. There has been no report comprehensively describing the profiles of circulating IL-6 levels in patients with AD so far. In order to highlight the potential role of the circulating IL-6 in patients with AD, a comprehensive review is conducted
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