Interleukin-6 as a therapeutic target in Diabetic macular edema: current evidence and future perspectives.

Authors

Hidetaka Noma, Tatsuya Mimura

Published in

Expert opinion on therapeutic targets. Aug 15, 2026. Epub Aug 15, 2026.

Abstract

Diabetic macular edema (DME) is a major cause of vision loss in diabetic retinopathy. Although anti-vascular endothelial growth factor (VEGF) therapy is the current standard treatment, many patients show incomplete responses, indicating the contribution of VEGF-independent mechanisms. Increasing evidence identifies interleukin-6 (IL-6) as a key mediator of inflammation, blood-retinal barrier disruption, and retinal vascular dysfunction in DME.
This review summarizes the biological functions and signaling pathways of IL-6 in DME and examines the clinical relevance of elevated intraocular IL-6 levels. We discuss the crosstalk between IL-6 and VEGF, review current evidence for IL-6-targeting agents, including tocilizumab and sarilumab, and evaluate their therapeutic potential, particularly in treatment-resistant DME.
IL-6 acts as a central hub cytokine linking chronic inflammation, vascular permeability, and retinal microvascular injury. By modulating both VEGF-dependent and VEGF-independent pathways, IL-6 inhibition represents a promising therapeutic strategy for refractory DME. Although direct clinical evidence remains limited, advances in biomarker-guided patient selection, local drug delivery systems, and combination approaches with anti-VEGF therapy may facilitate the development of precision medicine for DME.

PMID:
42603133
Bibliographic data and abstract were imported from PubMed on 15 Aug 2026.

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