Serum sST2 levels predict severe exacerbation of asthma

Abstract

BackgroundNeutrophilic inflammation is associated with poorly controlled asthma. Serum levels of sST2, a soluble IL-33 receptor, increase in neutrophilic lung diseases. We hypothesized that high serum sST2 levels in stable asthmatics are a predictor for exacerbation within a short duration.MethodsThis prospective observational study evaluated the serum sST2 levels of 104 asthmatic patients who were treated by a lung disease specialist with follow-ups for 3 months.ResultsHigh serum sST2 levels (> 18 ng/ml) predicted severe asthma exacerbation within 3 months. Serum sST2 levels correlated positively with asthma severity (treatment step), airway H2O2 levels, and serum IL-8 levels. High serum sST2 levels and blood neutrophilia (> 6000 /μl) were independent predictors of exacerbation. We defined a post-hoc exacerbation-risk score combining high serum sST2 level and blood neutrophilia, which stratified patients into four groups. The score predicted exacerbation-risk with an area under curve of 0.91 in the receiver operating characteristic curve analysis. Patients with the highest scores had the most severe phenotype, with 85.7% showing exacerbation, airflow limitation, and corticosteroid-insensitivity.ConclusionsHigh serum sST2 levels predicted exacerbation within the general asthmatic population and, when combined with blood neutrophil levels, provided an exacerbation-risk score that was an accurate predictor of exacerbation occurring within 3 months.Electronic supplementary materialThe online version of this article (10.1186/s12931-018-0872-2) contains supplementary material, which is available to authorized users.

IL-33/ST2 pathway regulates neutrophil migration and predicts outcome in patients with severe alcoholic hepatitis

“…Moreover, in patients initially classified as having good prognosis and who respond to therapy, the occurrence of an infection is responsible for a major drop in survival. 8 Circulating sST2 has been proposed as a biomarker in several diseases [34][35][36] and adding this marker to available scoring systems could optimize the prediction of clinical events in SAH. We show here using a large sample size and a robust methodology that sST2 not only predicts mortality but also the probability of getting infected in SAH and in cirrhosis, even though circulating levels of sST2 are different between the 2 conditions.…”

Anti-alarmins in asthma: targeting the airway epithelium with next-generation biologics

“…Furthermore, in patients with allergic asthma, ST2 expression on eosinophils from blood and sputum is significantly upregulated after allergen inhalation challenge [54]. Higher serum soluble ST2 levels are associated with an increased risk of exacerbations [63].…”

Contributions of IL-33 in Non-hematopoietic Lung Cells to Obstructive Lung Disease

“…Extracellular IL-33 activates immune cells and non-hematopoietic lung cells to promote immune responses, airway hyperresponsiveness and airway remodeling: aspects relevant to diseases such as asthma. (34), and idiopathic pulmonary fibrosis (35), and sST2 levels have been shown to correlate with acute exacerbations in these patients (35)(36)(37).…”