This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Interleukin 6 and the prognosis of abdominal aortic aneurysms. BJS 2001; 88: 601-602.
Published: 6th December 2002
Authors: K. G. Jones, L. C. Brown, D. J. Brull, S. E. Humphries, R. M. Greenhalgh, J. T. Powell et al.
Background
Abdominal aortic aneurysm (AAA) is a familial disorder, inflammation being an important pathophysiological feature. Increased plasma concentrations of the inflammatory cytokine interleukin (IL) 6 have been associated with AAA and early aortic dilatation. This study was designed to test the hypothesis that high concentrations of plasma IL‐6 and/or IL‐6 genotype predict rapid AAA growth.
Method
Genomic DNA from 466 patients, kept under ultrasonographic surveillance for small AAAs, was analysed for a G to C polymorphism at position −174 of the IL‐6 promoter. Baseline plasma IL‐6 concentration was measured by enzyme‐linked immunosorbent assay and AAA growth rates were calculated by linear regression.
Results
The median concentration of plasma IL‐6 was 4·9 (range 0–604) pg ml−1. IL‐6 concentration was not associated with aneurysm growth rate. The frequency of the C allele was 0·40, similar to that in the healthy population. Patients of GG genotype had a lower plasma concentration of IL‐6 than patients of either GC or CC genotype (median 1·9, 4·8 and 15·6 pg ml−1 respectively; P = 0·047, Kruskal–Wallis test). The AAA growth rate for patients of GG, GC and CC genotypes was 0·38, 0·36 and 0·36 cm per year respectively (P = 0·37). Mortality was lower for patients of GG genotype than for those with GC or CC genotype: hazard ratio 0·51 (95 per cent confidence interval (c.i.) 0·25–1·00), P = 0·05; and 0·32 (95 per cent c.i. 0·12–0·93), P = 0·036, for all‐cause and cardiovascular mortality respectively.
Conclusion
Genetic polymorphism is associated with clinical events in patients with an AAA. The G to C IL‐6 polymorphism at position −174 predicts future cardiovascular mortality. Neither plasma IL‐6 concentration nor IL‐6 genotype predicts AAA growth. © 2001 British Journal of Surgery Society Ltd
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