Background: Interleukin-6 (IL6) is a pleiotropic proinflammatory and immunomodulatory cytokine which probably plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). There is a functional single nucleotide polymorphism (SNP), -174G/ C, in the promoter region of IL6. It was hypothesised that IL6 SNPs influence susceptibility for impaired lung function and COPD in smokers. Methods: Seven and five SNPs in IL6 were genotyped in two nested case-control samples derived from the Lung Health Study (LHS) based on phenotypes of rate of decline of forced expiratory volume in 1 s (FEV 1 ) over 5 years and baseline FEV 1 at the beginning of the LHS. Serum IL6 concentrations were measured for all subjects. A partially overlapping panel of nine IL6 SNPs was genotyped in 389 cases of COPD from the National Emphysema Treatment Trial (NETT) and 420 controls from the Normative Aging Study (NAS). Results: In the LHS, three IL6 SNPs were associated with decline in FEV 1 (0.023(p(0.041 in additive models). Among them, the IL6_-174C allele was associated with a rapid decline in lung function. The association was more significant in a genotype-based analysis (p = 0.006). In the NETT-NAS study, IL6_-174G/C and four other IL6 SNPs, all of which are in linkage disequilibrium with IL6_-174G/C, were associated with susceptibility to COPD (0.01(p(0.04 in additive genetic models).
Conclusion:The results suggest that the IL6_-174G/C SNP is associated with a rapid decline in FEV 1 and susceptibility to COPD in smokers.Interleukin 6 (IL6) is a pleiotropic pro-inflammatory and immunomodulatory cytokine secreted by airway epithelial cells, alveolar macrophages, adipocytes and myocytes as well as other tissues and cells.1 2 The potential importance of IL6 in the pathogenesis of chronic obstructive pulmonary disease (COPD) is suggested by studies showing that high levels of serum or sputum IL6 are associated with impaired lung function or a faster decline in lung function.1 2 IL6 has been related to skeletal muscle weakness in COPD, 3 as well as to exacerbations 4 and pulmonary infections 5 in patients with COPD. In addition, overexpression of IL6 in the murine lung resulted in airway inflammation and emphysema-like airspace enlargement. 6 Furthermore, IL6 is an important mediator of the acute phase response and can upregulate C-reactive protein (CRP) at the transcriptional level.7 CRP has been associated with lung function levels in healthy individuals and/or lung function decline in smoking-induced COPD. Taken together, these data support IL6 as an appealing candidate gene for smoking-induced lung function impairment and COPD.The IL6 gene is located on chromosome 7p21. Previous studies have identified a functional single nucleotide polymorphism (SNP), -174G/C, in the promoter region of IL6.10 Before initiation of the current study, a small study reported no association of an IL6 SNP with COPD.11 Recently, another group showed that the IL6_-572C allele was associated with COPD.12 Large well-designed stu...