Overexpression of serum sST2 is associated with poor prognosis in acute-on-chronic hepatitis B liver failure

Background and 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 +/- 419.97 pg/ml) than those with CHB (97.25 +/- 174.67 pg/ml, P < 0.01) and HCs (28.39 +/- 6.53 pg/ml, P < 0.01). Serum sST2 was significantly higher in patients with ACHBLF (1545.87 +/- 1135.70 pg/ml) than those with CHB (152.55 +/- 93.28 pg/ml, P < 0.01) and HCs (149.27 +/- 104.90 pg/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), Log(10) [ 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 > 1507 pg/ml showed significantly poorer survival than those who had sST2 <= 1507 pg/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. (C) 2014 Elsevier Masson SAS. All rights reserved.