IL-6与VEGF互作驱动的视网膜静脉阻塞发病机制及多通路治疗策略探索
Exploration of the Pathogenic Mechanisms of Retinal Vein Occlusion Driven by IL-6 and VEGF Crosstalk and Multi-Pathway Therapeutic Strategies
DOI: 10.12677/acm.2026.1652151, PDF,    科研立项经费支持
作者: 吴坪遥：成都中医药大学眼科学院，四川 成都；成都中医药大学附属医院眼科，四川 成都；叶河江*：成都中医药大学附属医院眼科，四川 成都
关键词: 视网膜静脉阻塞；白细胞介素-6；血管内皮生长因子；多通路治疗；Retinal Vein Occlusion； Interleukin-6； Vascular Endothelial Growth Factor； Multi-Pathway Therapy
摘要: 视网膜静脉阻塞(Retinal Vein Occlusion, RVO)是高致盲性视网膜血管疾病，近年来其发病率不断上升。研究表明，炎症因子与血管内皮生长因子(Vascular Endothelial Growth Factor, VEGF)在RVO病程中协同驱动病理过程。其中，白细胞介素-6 (Interleukin-6, IL-6)通过JAKs激酶(Janus Kinases, JAKs)/信号转导和转录激活因子3 (Signal Transducer and Activator of Transcription 3, STAT3)通路诱导血–视网膜屏障(Blood-Retinal Barrier, BRB)破坏，并促进VEGF表达，而VEGF在缺血微环境中可进一步破坏BRB的紧密连接，致使渗透性增加，驱动了黄斑区的间质水肿与新生血管的萌生。基于IL-6与VEGF的互作机制，多通路联合干预具有潜在价值，尤其适用于难治性或炎症主导型RVO。文章综述IL-6与VEGF的分子作用机制、现有临床证据及双靶点药物临床思考，并提出未来研究方向，为抗VEGF反应不足病例提供新的治疗思路。
Abstract: Retinal vein occlusion (RVO) is a highly blinding retinal vascular disease, and its incidence has continued to increase in recent years. Emerging evidence indicates that inflammatory cytokines and vascular endothelial growth factor (VEGF) act synergistically to drive the pathological progression of RVO. Among these, interleukin-6 (IL-6) disrupts the blood-retinal barrier (BRB) via activation of the Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) signaling pathway and promotes VEGF expression. In ischemic microenvironments, VEGF further compromises tight junctions of the BRB, leading to increased permeability that drives macular interstitial edema and neovascular sprouting. Based on the mechanistic interplay between IL-6 and VEGF, multi-pathway combination therapy holds potential therapeutic value, particularly for refractory or inflammation-dominant RVO. This review summarizes the molecular mechanisms underlying IL-6 and VEGF interactions, current clinical evidence, and clinical considerations of dual-target therapeutic strategies, and proposes future research directions, aiming to provide novel treatment perspectives for patients with an inadequate response to anti-VEGF therapy.
文章引用：吴坪遥, 叶河江. IL-6与VEGF互作驱动的视网膜静脉阻塞发病机制及多通路治疗策略探索[J]. 临床医学进展, 2026, 16(5): 3298-3305. https://doi.org/10.12677/acm.2026.1652151

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