Association of IL-6 polymorphism -174G/C and metabolic syndrome in hypertensive patients

Revisiting the Immunometabolic Basis for the Metabolic Syndrome from an Immunonutritional View

Metabolic syndrome (MetS) implies different conditions where insulin resistance constitutes a major hallmark of the disease. The disease incurs a high risk for the development of cardiovascular complications, and takes its toll in regard to the gut-liver axis (pancreas, primary liver and colorectal)-associated immunity. The modulation of immunometabolic responses by immunonutritional factors (IFs) has emerged as a key determinant of the gut-liver axis' metabolic and immune health. IFs from plant seeds have shown in vitro and pre-clinical effectiveness primarily in dealing with various immunometabolic and inflammatory diseases. Only recently have immunonutritional studies established the engagement of innate intestinal immunity to effectively control immune alterations in inflamed livers preceding the major features of the MetS. However, integrative analyses and the demonstration of causality between IFs and specific gut-liver axis-associated immunometabolic imbalances for the MetS remain ill-defined in the field. Herein, a better understanding of the IFs with a significant role in the MetS, as well as within the dynamic interplay in the functional differentiation of innate immune key effectors (i.e., monocytes/macrophages), worsening or improving the disease, could be of crucial relevance. The development of an adequate intermediary phenotype of these cells can significantly contribute to maintaining the function of Tregs and innate lymphoid cells for the prevention and treatment of MetS and associated comorbidities.

IL-6/STAT3 and adipokine modulation using tocilizumab in rats with fructose-induced metabolic syndrome

Metabolic syndrome (MetS) is a low-grade inflammation state that results from an interplay between genetic and environmental factors. The incidence of MetS among individuals with insulin resistance, dyslipidemia, elevated blood pressure, and obesity, which constitute the syndrome, is 40% in the Middle East. The absence of an approved therapeutic agent for MetS is one reason to investigate tocilizumab (TCZ), which might be effective in the treatment of MetS. Results have implicated interleukin 6 (IL-6) in the development of MetS, identifying inflammation as a critical factor in its etiology and offering hope for new therapeutic approaches development. Here, we evaluate whether tocilizumab can be used for metabolic syndrome treatment. We assigned rats to three groups, 8 rats each: a negative-control group, provided with standard rodent chow and water; a fructose-fed group, provided with standard rodent chow and 10% fructose in drinking water for 22 weeks; and a treatment group, fed as per the metabolic syndrome group but treated with tocilizumab (5 mg/kg/week, intraperitoneal) for the final 5 weeks. Treatment with TCZ successfully ameliorated the damaging effects of fructose by stabilizing body weight gain and through the normalization of serum biochemical parameters and histopathological examination. Significant differences in adipokine levels were perceived, resulting in a significant decline in serum leptin and interleukin 6 (IL-6) levels concurrent with adiponectin normalization. Tocilizumab might be an effective agent for the treatment of metabolic syndrome. However, further investigations on human subjects are needed before the clinical application of tocilizumab for this indication.

The role of IL-6-174 G/C polymorphism and intraocular IL-6 levels in the pathogenesis of ocular diseases: a systematic review and meta-analysis

Interleukin-6 (IL-6) is one of the key regulators behind the inflammatory and pathological process associated with ophthalmic diseases. The role of IL-6-174 G/C polymorphism as well as intraocular IL-6 levels among various eye disease patients differ across studies and has not been systematically reviewed. Thus, this study aims to provide a summary to understand the relationship between IL-6 and ophthalmic disease. In total, 8,252 and 11,014 subjects for IL-6-174 G/C and intraocular levels of IL-6, respectively, were retrieved from PubMed, Scopus and Web of Science. No association was found between IL-6-174 G/C polymorphisms with ocular diseases. Subgroup analyses revealed a suggestive association between the GC genotype of IL-6-174 G/C with proliferative diabetic retinopathy (PDR). Further, the level of intraocular IL-6 among ocular disease patients in general was found to be higher than the control group [standardized mean difference (SMD) = 1.41, 95% confidence interval (CI) 1.24-1.58, P < 0.00001]. Closer examination through subgroup analyses yielded similar results in several ocular diseases. This study thus indicates that the IL-6-174 G/C polymorphism does not predispose patients to ocular disease, although the GC genotype is likely to be a genetic biomarker for PDR. Moreover, intraocular IL-6 concentrations are related to the specific manifestations of the ophthalmic diseases. Further studies with larger sample sizes are warranted to confirm this conclusion.

Association of interleukin-6 polymorphisms with obesity: A systematic review and meta-analysis

Obesity is a common metabolic disorder with increasing trend all around the world. Owing to the role of pro-inflammatory cytokines on obesity, we aimed to investigate the role of interleukin-6 (IL-6) polymorphisms on risk of obesity. Electronic literatures were searched in Web of Science, PubMed, Embase, and Scopus. The references of relevant reviews and included studies were also manually checked. All types of observational studies from 1 January 1992 to 28 February 2018 were included. Odds ratio (OR) was estimated by fixed and random effect model. Subgroup analysis was carried out based on age statues. Pooling analysis of eligible studies have been considered for rs2069845 and rs1800796, and no significant results were observed. Minor allele of IL-6 rs1800797polymorphism decreased the risk of obesity/overweight in allelic 0.74 (0.59-0.92), dominant 0.65 (0.49-0.85), and over-dominant 0.66 (0.51-0.87) models. Fourteen eligible studies were included for rs1800795. According to BMI, C allele showed increased risk of obesity in genetic models containing homozygote model 1.47 (1.02-2.12) for body mass index (BMI) ≥ 25 vs. BMI < 25, recessive model 1.32 (1.07-1.63) for BMI ≥ 30 vs. BMI < 25, and homozygote model 1.35 (1.10-1.66) for BMI ≥ 30 vs. BMI < 30. In overall definition of obesity more significant results were observed, including homozygote model in obese vs. normal 1.71 (1.14-2.56). Similarly, subgroups analysis revealed additional significant results. Minor alleles of rs1800795 raised and rs1800797 reduced the risk of obesity, while rs1800796 and rs2069845 may not be associated. However, more observational studies are recommended to confirm these results.

Association of the IL6 Gene Polymorphism with Component Features of Metabolic Syndrome in Obese Subjects

Metabolic syndrome (MetS) is a risk factor for type 2 diabetes mellitus and cardiovascular disease. Obesity is a component of the metabolic syndrome. Several genetic variants are reported to be associated with obesity and hypo adiponectinemia, including ars1800796 polymorphism of the interleukin-6 (IL-6) gene. Since obesity is associated with inflammatory factors, the aim of this study was to investigate the association between this polymorphism and MetS and its related features. Obese patients with body mass index (BMI) ≥ 30 (n = 182) were recruited into this study and divided into two groups; 110 patients with MetS, based on the International Diabetes Federation (IDF) criteria, and 72 subjects without MetS. The anthropometric and biochemical data for the groups were compared. Genotyping was carried out using RT-PCR. The association of the genetic polymorphism with MetS and its components were assessed using univariate and multivariate analyzes. There was an association between the presence of the rs1800796polymorphism of the IL-6 gene, with BMI (P = 0.031), high-density lipoprotein (HDL) (P = 0.010) and low-density lipoprotein (LDL) (P = 0.037), while this genetic variant did not show any significant association with the presence of MetS as defined by the IDF. We demonstrate an association between the rs1800796 genetic variant of the IL-6 gene with components of MetS including BMI, and HDL-cholesterol, but not the MetS itself. Therefore, supporting further studies are warranted to investigate this point in a larger population.

A Systematically Assembled Signature of Genes to be Deep-Sequenced for Their Associations with the Blood Pressure Response to Exercise

: Background: Exercise is one of the best nonpharmacologic therapies to treat hypertension. The blood pressure (BP) response to exercise is heritable. Yet, the genetic basis for the antihypertensive effects of exercise remains elusive. Methods: To assemble a prioritized gene signature, we performed a systematic review with a series of Boolean searches in PubMed (including Medline) from earliest coverage. The inclusion criteria were human genes in major BP regulatory pathways reported to be associated with: (1) the BP response to exercise; (2) hypertension in genome-wide association studies (GWAS); (3) the BP response to pharmacotherapy; (4a) physical activity and/or obesity in GWAS; and (4b) BP, physical activity, and/or obesity in non-GWAS. Included GWAS reports disclosed the statistically significant thresholds used for multiple testing. Results: The search yielded 1422 reports. Of these, 57 trials qualified from which we extracted 11 genes under criteria 1, 18 genes under criteria 2, 28 genes under criteria 3, 27 genes under criteria 4a, and 29 genes under criteria 4b. We also included 41 genes identified from our previous work. Conclusions: Deep-sequencing the exons of this systematically assembled signature of genes represents a cost and time efficient approach to investigate the genomic basis for the antihypertensive effects of exercise.

An integrative review of associations between polymorphic variants and the metabolic syndrome

The pathogenesis of metabolic syndrome, i.e. of each of its components, is complex and has not been entirely elucidated. As a result, it is very difficult to establish a definition of which clinical factors are the most important determinants of its development. The objective of this review is to describe Brazilian scientific research investigating associations between the metabolic syndrome and genetic factors. We selected fifteen studies that met the inclusion and exclusion criteria. Our analysis revealed that there is a modest volume of Brazilian studies investigating relationships between genes, their polymorphic variants and the metabolic syndrome and its risk factors. Therefore, more studies are needed to better understand the biological roles played by genetic polymorphisms and their relationships with metabolic syndrome or its risk factors.

Correlation between the expression of inflammatory cytokines IL-6, TNF-α and hs-CRP and unfavorable fetal outcomes in patients with pregnancy-induced hypertension

The expression of inflammatory factors, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP), in patients with pregnancy-induced hypertension (PIH) was investigated, to analyze correlation of expression levels of these factors in patients with unfavorable fetal outcome. A total of 100 patients diagnosed with PIH treated in Jining First People's Hospital (Jining, China) from January 2012 to October 2017 were selected as the experimental group, while 100 normal pregnant women during the same period were selected as the control group. Results showed that the levels of IL-6, TNF-α and hs-CRP in patients with PIH were significantly higher than those in normal pregnant women (p<0.01). There were significant differences in levels of IL-6, TNF-α and hs-CRP among patients with hypertension in different degrees. The expression levels of IL-6, TNF-α and hs-CRP in PIH patients with favorable pregnancy outcome were lower than those in patients with unfavorable pregnancy outcome (p<0.05). Moreover, the expression levels of IL-6, TNF-α and hs-CRP had a linearly positive correlation with systolic blood pressure in PIH patients. Age, height and weight had no significant correlation with unfavorable pregnancy outcome of PIH patients (p>0.05). Finally, inflammatory factors (TNF-α, IL-6 and hs-CRP) and blood pressure were obviously and positively correlated with unfavorable pregnancy outcome of PIH patients (p<0.05). In conclusion, the expression of inflammatory factors (TNF-α, IL-6 and hs-CRP) in PIH patients are positively correlated with the systolic blood pressure and unfavorable fetal outcome of patients, which can be used as indexes of prognosis evaluation of PIH patients.

Association Between Interleukin-6 -572 C>G and -174 G>C Polymorphisms and Hypertension: A Meta-analysis of Case-control Studies

Whether hypertension is associated with -572 C>G or -174 G>C polymorphism in interleukin (IL)-6 genes still remains hazy and ambiguous.We conducted a meta-analysis to offer a more reliable and clearer evaluation about the association.Electronic literature databases including PubMed, Web of Science, EMBASE, Google Scholar, Chinese National Knowledge Infrastructure and Wanfang database were searched.The study included the following: evaluating associations between -572 C>G or -174 G>C polymorphism in IL-6 gene and hypertension; case-control design; essential information must be offered; precise diagnostic criteria of hypertension; and no language restriction.Patients who met the diagnostic criteria and controls without a history of hypertension were included. Interventions were not available.A quality assessment was conducted using Newcastle-Ottawa scale. Combined odds ratios with 95% confidence intervals were calculated in 5 genetic models. Sources of heterogeneity were explored by subgroup analysis, meta-regression, and Galbraith plots. Finally, test for publication bias was performed to prove the stabilization.Fifteen studies were finally included. Eleven articles were judged high-quality reports. Overall, the -572 C>G polymorphism was proved to be significantly associated with hypertension in 4 genetic models. Subgroup analysis based on ethnicity revealed significant associations in Asian population in recessive model and homozygote comparison. The association in Europeans and Mid-East required further confirmation. No significant association was observed between the -174 G>C polymorphism and hypertension under all of the genetic models.The limitations of the study were the following: restrictive number of eligible studies limited the extrapolation range in subgroup analysis; gene-environment factors could not be described due to lack of data; some relevant studies could not be included because of various reasons.Current researches supported the association between the development of hypertension and the -572 C>G rather than -174 G>C polymorphism. Future well designed epidemiological studies may evaluate the possible gene-environment interactions.