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The role of interleukin‐6 in the human adrenal gland

Interleukin (IL)‐6 is a potent activator of the hypothalamic–pituitary–adrenal (HPA) axis on all levels in humans, and appears to play a pathogenic role in conditions related to chronic stress and physiological ageing; with physiological ageing showing a similar hormonal and immunological pattern to chronic stress. IL‐6 and its receptor IL‐6R are coexpressed at similar sites in the human adrenal gland, which seems to be an important source of IL‐6 production. In vitro, in primary cultures of adrenal gland cells, chronic exposure to IL‐6 stimulates adrenocortical steroid release in a time‐ and dose‐dependent manner. This explains the high systemic cortisol levels in the absence of adequate plasma concentrations of corticotropin (ACTH) observed in patients after long‐term treatment with IL‐6. It could therefore be concluded that in situations of prolonged stress, when corticotropin‐releasing hormone and ACTH release are suppressed by feedback inhibition due to circulating glucocorticoids, IL‐6 maintains the elevated glucocorticoid levels by direct stimulation of adrenocortical steroidogenesis via autocrine/paracrine mechanisms.