title: Overexpression of serum sST2 is associated with poor prognosis in acute-on-chronic hepatitis B liver failure.
abstract: OBJECTIVE
  Interleukin-33 (IL-33) and soluble ST2 (sST2) have been demonstrated to be involved in liver injury. The present study aims to evaluate serum IL-33 and sST2 level in acute-on-chronic hepatitis B liver failure (ACHBLF) and determine their predictive value for prognosis.
  
  
  METHODS
  Serum IL-33 and sST2 level in patients with ACHBLF, chronic hepatitis B (CHB) and healthy controls (HCs) were determined by enzyme-linked immunosorbent assay (ELISA). Clinical and laboratory parameters were obtained.
  
  
  RESULTS
  Serum IL-33 was significantly higher in patients with ACHBLF (313.10±419.97pg/ml) than those with CHB (97.25±174.67pg/ml, P<0.01) and HCs (28.39±6.53pg/ml, P<0.01). Serum sST2 was significantly higher in patients with ACHBLF (1545.87±1135.70pg/ml) than those with CHB (152.55±93.28pg/ml, P<0.01) and HCs (149.27±104.90pg/ml, P<0.01). In all participants, serum IL-33 was significantly correlated with sST2 (r=0.43, P<0.01). In patients with ACHBLF, serum IL-33 was significantly correlated with alanine aminotransferase (ALT; r=0.26, P=0.04). Serum sST2 was significantly correlated with total bilirubin (TBIL; r=0.59, P<0.01), Log10 [HBV DNA] (r=-0.47, P<0.01) and model for end-stage liver diseases (MELD; r=0.28, P=0.03). Serum sST2 had an area under the receiver operating characteristic curve (AUC) of 0.81 in predicting 3-month mortality of ACHBLF. Patients with ACHBLF who had sST2 >1507pg/ml showed significantly poorer survival than those who had sST2 ≤1507pg/ml (P<0.01). Moreover, measurement of sST2 and MELD together significantly improved the diagnostic value of MELD alone (P<0.05).
  
  
  CONCLUSIONS
  Our study showed that serum IL-33 and sST2 were overexpressed in ACHBLF and sST2 might potentially serve as a prognostic marker for it.
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China.
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Huan
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China; Institute of Hepatology, Shandong University, Jinan 250012, Shandong, China.
authors.forename: Li-Yan
authors.initials: LY
authors.lastname: Han
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China.
authors.forename: Xiang-Fen
authors.initials: XF
authors.lastname: Ji
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China.
authors.forename: Xin-You
authors.initials: XY
authors.lastname: Li
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China; Institute of Hepatology, Shandong University, Jinan 250012, Shandong, China.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Fan
authors.affiliation: Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China; Institute of Hepatology, Shandong University, Jinan 250012, Shandong, China. Electronic address: wangdoc876@126.com.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000097:blood* / Q000209:etiology; D000328:Adult; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33 / Q000096:biosynthesis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000096:biosynthesis / Q000097:blood*; D055815:Young Adult
chemical_list: C079241:IL1RL1 protein, human; C506536:IL33 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D011956:Receptors, Cell Surface