Serum soluble ST2 is a promising prognostic biomarker in HBV-related acute-on-chronic liver failure
Serum soluble ST2 is a promising prognostic biomarker in HBV-related acute-on-chronic liver failure
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DOI：
10.1016/s1499-3872(16)60185-6
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发表时间：
2017-04-01
影响因子：
3.3
通讯作者：
Xie, Qing
中科院分区：
文献类型：
--
作者：
Jiang, Shao-Wen;Wang, Peng;Xie, Qing
背景：IL-33/ST 2轴参与了自身免疫性疾病、癌症、心力衰竭等多种疾病的发病机制。然而，IL-33/ST 2通路在HBV相关的慢加急性肝功能衰竭（HBV-ACLF）中的研究还很缺乏。方法：采用酶联免疫吸附试验（ELISA）检测18例健康对照组（HC）、27例慢性B型肝炎（CH B）和51例HBV-ACLF患者入组后第1周和第4周血清IL-33和sST 2水平，并收集临床资料。结果：HC、CHB、HBV-ACLF患者第1周血清IL-33水平差异无统计学意义。血清sST 2水平在HBV-ACLF组最高，CHB组次之，HC组最低。血清sST 2水平与HBV-ACLF患者的生存率呈负相关。HBV-ACLF存活者血清sST 2水平在治疗后1 ~ 4周显著下降，而HBV-ACLF未存活者血清sST 2水平在治疗后1 ~ 4周维持在较高水平。此外，血清sST 2水平与实验室参数和最新预后评分（CLIF-C OF评分、CLIF-C ACLF评分和ACLF分级）显著相关。受试者工作特征曲线表明血清sST 2水平是预测HBV-ACLF患者6个月死亡率的良好诊断指标，与最新预后评分相当。预测HBV-ACLF患者预后的血清sST 2临界点分别为第1周76 ng/mL或第4周53 ng/mL。结论：血清sST 2可作为评估HBV-ACLF患者病情严重程度和预测预后的生物标志物，有助于HBV-ACLF高危患者的早期识别和治疗。
BACKGROUND: The IL-33/ST2 axis is involved in the pathogenesis of many diseases such as autoimmune diseases, cancer, and heart failure. However, studies of the IL-33/ST2 pathway in HBV-related acute-on-chronic liver failure (HBV-ACLF) are lacking. The present study aimed to determine the prognostic role of serum IL-33/soluble ST2 (sST2) in HBV-ACLF.METHODS: Serum levels of IL-33 and sST2 in healthy controls (HC, n=18), chronic hepatitis B (CHB, n=27) and HBV-ACLF (n=51) patients at the 1st and 4th week after enrollment were detected using ELISA, and clinical data were collected. The follow-up of HBV-ACLF patients lasted for 6 months at least.RESULTS: There was no significant difference of serum IL-33 level among HC, CHB and HBV-ACLF patients at week 1. However, serum sST2 level differed significantly among the three groups: highest in the HBV-ACLF group, moderate in the CHB group and lowest in the HC group. There was a reverse correlation between serum sST2 level and the survival of HBV-ACLF patients. The level of serum sST2 in HBV-ACLF survivors was significantly declined from week 1 to week 4 following the treatment, whereas that in HBV-ACLF non survivors remained at a high level during the same period. Furthermore, serum sST2 level was significantly correlated with laboratory parameters and the most updated prognostic scores (CLIF-C OF score, CLIF-C ACLF score and ACLF grades). The receiver operating characteristics curves demonstrated that serum sST2 level was a good diagnostic marker for predicting the 6-month mortality in HBV-ACLF patients, comparable to the most updated prognostic scores. Serum sST2 cut-off points for predicting prognosis in HBV-ACLF patients were 76 ng/mL at week 1 or 53 ng/mL at week 4, respectively. HBV-ACLF patients with serum sST2 level above the cut-off point often had a worse prognosis than those below the cut-off point.CONCLUSION: Serum sST2 may act as a promising biomarker to assess severity and predict prognosis of patients with HBV-ACLF and help for the early identification and optimal treatment of HBV-ACLF patients at high risk of mortality.