title: Up-regulation of interleukin 33 and soluble ST2 serum levels in liver failure.
abstract: BACKGROUND
  IL-33, a member of the IL-1 family, induces the production of pro-inflammatory and Th2-associated cytokines and may also serve as an 'alarmin' similar to HMGB1. Soluble ST2 has been implicated as a decoy receptor, to attenuate Th2 inflammatory responses. The relevance of both molecules in hepatic failure is unknown.
  
  
  METHODS
  The trial was a prospective preliminary study in a university hospital surgical ICU; 11 patients with acute liver failure (ALF) and 12 patients with acute-on-chronic liver failure (ACLF), who were admitted to the ICU; 14 patients with chronic hepatic failure (CHF) awaiting liver transplantation; 13 healthy individuals served as controls. IL-33 and soluble ST2 concentrations were determined by enzyme linked immunosorbent assay (ELISA).
  
  
  RESULTS
  The concentration of IL-33 and soluble ST2 was significantly higher in ALF, ACLF, and CHF patients compared with the controls. Soluble ST2 serum concentration was significantly elevated in ALF and ACLF compared with CHF; moreover, soluble ST2 was significantly higher in CHF compared with healthy controls. IL-33 and soluble ST2 serum levels correlated significantly (r = 0.6117, P < 0.0001). Moreover, there was a correlation between IL-33 serum levels and alanine aminotransferase (ALT) activity in CHF, ALF, and ACLF patients (r = 0.4321, P = 0.0171).
  
  
  CONCLUSIONS
  Our data provide evidence for elevated levels of IL-33 and soluble ST2 in liver failure, which could a sign of immune hyperactivation, and/or a mechanism to down-regulate inflammation. Especially, soluble ST2 maybe useful to discern acute from chronic hepatic failure or to monitor the course and the severity of the disease.
authors.affiliation: Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria. georg.roth@meduniwien.ac.at
authors.forename: Georg A
authors.initials: GA
authors.lastname: Roth
authors.forename: Matthias
authors.initials: M
authors.lastname: Zimmermann
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Lubsczyk
authors.forename: Johannes
authors.initials: J
authors.lastname: Pilz
authors.forename: Peter
authors.initials: P
authors.lastname: Faybik
authors.forename: Hubert
authors.initials: H
authors.lastname: Hetz
authors.forename: Stefan
authors.initials: S
authors.lastname: Hacker
authors.forename: Andreas
authors.initials: A
authors.lastname: Mangold
authors.forename: Andreas
authors.initials: A
authors.lastname: Bacher
authors.forename: Claus G
authors.initials: CG
authors.lastname: Krenn
authors.forename: Hendrik Jan
authors.initials: HJ
authors.lastname: Ankersmit
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000276:immunology; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D007378:Interleukins / Q000097:blood*; D017093:Liver Failure / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011956:Receptors, Cell Surface / Q000097:blood*; D018418:Th2 Cells / Q000276:immunology; D015854:Up-Regulation
chemical_list: C079241:IL1RL1 protein, human; C506536:IL33 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D007378:Interleukins; D011956:Receptors, Cell Surface; D000410:Alanine Transaminase