ST2 levels in blood predict patient prognosis
ST2 has been known for many years, principally for its role in T-cell differentiation. In 2002, researchers reported the novel discovery of increased ST2 expression in cultured rat cardiomyocytes subjected to mechanical stretch emulating the in vivo phenomenon of volume overload in heart failure 1. At that time, the ligand for ST2 was unknown and it was considered an orphan receptor.
In 2005, researchers reported the discovery of the ligand for ST2 and named it IL-332. The direct involvement of the ST2/IL-33 signaling system was subsequently confirmed in animal models subjected to cardiac insult3. These studies demonstrated that an intact ST2/IL-33 signal system provides a cardioprotective effect while a missing or blocked signal results in increased cardiac hypertrophy and fibrosis.
The following images, from a blinded and randomized study of ischemia/reperfusion in rats, illustrate this phenomenon. IL-33 treatment significantly reduced fibrosis compared to control-treated rats (p<0.05). These results confirm that following cardiac insult by ischemic injury ST2/IL-33 signaling provides a level of cardioprotection and reduced risk of mortality.
Control
Red corresponds to cardiomyocytes and blue stain corresponds to fibrosis
This anti-fibrotic effect was further found, using genetic ST2 knockout mouse models, to depend on the presence and absence of ST2, either as the signaling membrane-bound receptor or as an interfering soluble “decoy receptor.” It has been subsequently demonstrated that high levels of soluble ST2 can reduce or block IL-33’s activity, thus preventing the cardioprotective effect.
Soluble ST2 has now been published in more than 40 peer-reviewed articles studying more than 20,000 patients. These clinical studies have demonstrated that high levels of soluble ST2 are predictive of adverse patient outcomes and death in a broad spectrum of cardiovascular disease. They have further shown that the prognostic information from soluble ST2 is independent of, and provides added information to, that of biomarkers commonly used today, including the natriuretic peptides.
By using the Presage® ST2 Assay, the patient’s soluble ST2 concentration can be quantitatively measured, providing new insight into patient prognosis and disease progression.
In 2005, researchers reported the discovery of the ligand for ST2 and named it IL-332. The direct involvement of the ST2/IL-33 signaling system was subsequently confirmed in animal models subjected to cardiac insult3. These studies demonstrated that an intact ST2/IL-33 signal system provides a cardioprotective effect while a missing or blocked signal results in increased cardiac hypertrophy and fibrosis.
The following images, from a blinded and randomized study of ischemia/reperfusion in rats, illustrate this phenomenon. IL-33 treatment significantly reduced fibrosis compared to control-treated rats (p<0.05). These results confirm that following cardiac insult by ischemic injury ST2/IL-33 signaling provides a level of cardioprotection and reduced risk of mortality.
Control
Red corresponds to cardiomyocytes and blue stain corresponds to fibrosis
This anti-fibrotic effect was further found, using genetic ST2 knockout mouse models, to depend on the presence and absence of ST2, either as the signaling membrane-bound receptor or as an interfering soluble “decoy receptor.” It has been subsequently demonstrated that high levels of soluble ST2 can reduce or block IL-33’s activity, thus preventing the cardioprotective effect.
Soluble ST2 has now been published in more than 40 peer-reviewed articles studying more than 20,000 patients. These clinical studies have demonstrated that high levels of soluble ST2 are predictive of adverse patient outcomes and death in a broad spectrum of cardiovascular disease. They have further shown that the prognostic information from soluble ST2 is independent of, and provides added information to, that of biomarkers commonly used today, including the natriuretic peptides.
By using the Presage® ST2 Assay, the patient’s soluble ST2 concentration can be quantitatively measured, providing new insight into patient prognosis and disease progression.
Back to Top Please Note : The Presage® ST2 Assay is CE Marked and has received 510(k) clearance from the US FDA.
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© Critical Diagnostics. All rights reserved. Call us: (877) 700-1250 or (858) 270-2400 Email us
