心力衰竭中的可溶性 ST2。

Soluble ST2 in heart failure.

机构信息

Department of Laboratory Medicine, Konventhospital Barmherzige Brueder, Linz, Austria.

出版信息

Clin Chim Acta. 2015 Mar 30;443:57-70. doi: 10.1016/j.cca.2014.09.021. Epub 2014 Sep 28.

DOI:10.1016/j.cca.2014.09.021

Abstract

In addition to routine clinical laboratory tests (including natriuretic peptides and cardiac troponins), other biomarkers are gaining attention for their utility in heart failure (HF) management. Among them, soluble ST2 (sST2) a novel biomarker integrating inflammation, fibrosis, and cardiac stress has been included in the 2013 ACCF/AHA guideline for additive risk stratification of patients with acute and chronic HF. sST2 is an interleukin-1 (IL-1) receptor family member, is secreted into the circulation and functions as a "decoy" receptor for IL-33, inhibiting IL-33/ST2 signaling. Blood concentrations of sST2 are increased in various diseases such as inflammatory diseases and heart diseases and are considered a valuable prognostic marker in both conditions. sST2 lacks disease specificity and, therefore, is not a valuable marker for the diagnosis of HF. In acute and chronic HF, however, sST2 is strongly associated with measures of HF severity and poor outcome. Several studies in patients with HF indicate that serial measurement of sST2 has prognostic value and could have a potential role in future biomarker-directed therapy. In this review, the role of sST2 as a HF biomarker will be discussed, specifically addressing analytical considerations of measuring sST2 as well as the clinical applications of measurement of sST2 for the diagnosis, prognosis and monitoring of acute and chronic HF.

摘要

除了常规的临床实验室检查（包括利钠肽和心脏肌钙蛋白）外，其他生物标志物因其在心力衰竭（HF）管理中的应用而受到关注。其中，可溶性 ST2（sST2）是一种新型生物标志物，整合了炎症、纤维化和心脏应激，已被纳入 2013 年 ACCF/AHA 急性和慢性 HF 患者附加风险分层指南。sST2 是白细胞介素-1（IL-1）受体家族成员，分泌到循环中，作为 IL-33 的“诱饵”受体，抑制 IL-33/ST2 信号。sST2 在各种疾病中（如炎症性疾病和心脏病）的血液浓度增加，被认为是这两种疾病中有价值的预后标志物。sST2 缺乏疾病特异性，因此不是 HF 诊断的有价值标志物。然而，在急性和慢性 HF 中，sST2 与 HF 严重程度和不良预后的测量指标密切相关。几项 HF 患者的研究表明，sST2 的连续测量具有预后价值，并可能在未来的基于生物标志物的治疗中发挥作用。在这篇综述中，将讨论 sST2 作为 HF 生物标志物的作用，特别是讨论测量 sST2 的分析注意事项，以及测量 sST2 对急性和慢性 HF 的诊断、预后和监测的临床应用。