title: Soluble ST2 plasma concentrations predict mortality in HBV-related acute-on-chronic liver failure.
abstract: Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a rapidly progressing and frequently fatal condition. The aim of this study was to determine whether interleukin- (IL-) 33 and soluble ST2 (sST2) were associated with disease severity and mortality in HBV-ACLF. We found that plasma levels of sST2 but not IL-33 were higher in HBV-ACLF patients compared with chronic hepatitis B (CHB) patients and healthy controls. However, plasma levels of IL-33, TNF-α, IFN-γ, and IL-10 did not correlate with sST2 levels. Similarly, immunohistochemistry revealed low IL-33 expression and high ST2 expression in liver sections of patients with HBV-ACLF. Evaluation of dynamic changes of sST2 in HBV-ACLF showed that plasma sST2 levels increased over time in patients who died during the 180-day follow-up but decreased in those who survived. In addition, plasma sST2 level after week 1 correlated with disease severity, as assessed by total bilirubin, prothrombin time, and model for end-stage liver disease score. Results of Kaplan-Meier survival analysis showed that higher sST2 concentration (≥87 ng/mL) at week 3 was associated with poor survival. These findings indicate the potential usefulness of sST2 as a predictor of disease severity and in making treatment decisions for patients with HBV-ACLF.
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Ziying
authors.identifier: 0000-0002-7734-5352
authors.initials: Z
authors.lastname: Lei
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Zhishuo
authors.initials: Z
authors.lastname: Mo
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Jianyun
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Xiuqing
authors.initials: X
authors.lastname: Pang
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Xingrong
authors.identifier: 0000-0001-7000-4953
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Zhebin
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Dongying
authors.initials: D
authors.lastname: Xie
authors.affiliation: Department of Infectious Disease, The Third Affiliated Hospital of Sun-Yet-Sen University, Guangzhou, Guangdong 510630, China ; Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, Guangzhou, Guangdong 510080, China.
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Gao
mesh_terms: D065290:Acute-On-Chronic Liver Failure / Q000097:blood* / Q000401:mortality; D000328:Adult; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000401:mortality; D006801:Humans; D007118:Immunoassay; D007150:Immunohistochemistry; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33 / Q000097:blood; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011956:Receptors, Cell Surface / Q000097:blood*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D016207:Cytokines; C079241:IL1RL1 protein, human; C506536:IL33 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D000067596:Interleukin-33; D011956:Receptors, Cell Surface; D001663:Bilirubin