Objective

Interleukin-33 (IL-33) has been investigated as a mediator in the pathogenesis of fibrosis in lung, liver, and heart. There is accumulating evidence for the involvement of the IL-33/IL-33 receptor ST2L signalling pathway in systemic sclerosis (SSc). Little is known about the role of serum sST2 in SSc, which is the subject of the present investigation.

Method

Serum levels of sST2 were measured in 49 patients with SSc, recruited prospectively between November 2017 and March 2019. Patients were divided into those with progressive and those with stable disease. Receiver operating characteristics (ROC) curve analysis was applied to study sST2 as a marker for identifying patients with progressive disease. We used multivariate logistic regression analysis to evaluate the predictive value of sST2 for progressive disease after adjustment for potential confounding factors.

Results

Serum sST2 levels in patients with progressive disease were significantly elevated compared with patients with stable disease (mean ± sem: 50.4 ± 4.7 ng/mL vs 29.2 ± 2.97 ng/mL, p < 0.001). ROC curve analysis identified an sST2 cut-off value of 37.8 ng/mL as optimal for discriminating patients with progressive disease from those with stable disease (sensitivity 80.0%, specificity 79.3%, area under the curve 0.80). After controlling for potential confounding factors (age, gender, C-reactive protein, pro-brain natriuretic peptide, and sum of internal medicine comorbidities), sST2 remained predictive of progressive disease (odds ratio 1.070, 95% confidence interval 1.017–1.126, p < 0.009).

Conclusion

In the present study, sST2 serum levels were predictive of disease progression in patients with SSc.

中文翻译：

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可溶性 ST2 血清水平升高作为系统性硬化症疾病进展的预测因子

客观的

白细胞介素 33 (IL-33) 已被研究作为肺、肝和心脏纤维化发病机制的介质。越来越多的证据表明 IL-33/IL-33 受体 ST2L 信号通路参与系统性硬化症 (SSc)。关于血清 sST2 在 SSc 中的作用知之甚少，这是本研究的主题。

方法

在 2017 年 11 月至 2019 年 3 月期间前瞻性招募的 49 名 SSc 患者中测量了 sST2 的血清水平。患者分为进展期和疾病稳定期。接受者操作特征 (ROC) 曲线分析用于研究 sST2 作为识别疾病进展患者的标志物。在调整了潜在的混杂因素后，我们使用多变量逻辑回归分析来评估 sST2 对疾病进展的预测价值。

结果

与疾病稳定的患者相比，疾病进展患者的血清 sST2 水平显着升高（平均值 ± sem：50.4 ± 4.7 ng/mL vs 29.2 ± 2.97 ng/mL，p < 0.001）。ROC 曲线分析确定 37.8 ng/mL 的 sST2 截止值是区分疾病进展患者与疾病稳定患者的最佳选择（敏感性 80.0%，特异性 79.3%，曲线下面积 0.80）。在控制了潜在的混杂因素（年龄、性别、C 反应蛋白、前脑利钠肽和内科合并症总和）后，sST2 仍可预测疾病进展（优势比 1.070，95% 置信区间 1.017-1.126，p < 0.009)。

结论

在本研究中，sST2 血清水平可预测 SSc 患者的疾病进展。