ST2 cardiac biomarker
ST2 Cardiac Biomarker is a protein that plays a significant role in cardiovascular disease diagnosis and prognosis. It is a member of the interleukin 1 receptor family and is also known as interleukin 1 receptor-like 1 (IL1RL1). The ST2 protein exists in two forms: a transmembrane form (ST2L) and a soluble form (sST2). The soluble form is of particular interest in the context of cardiology, as it is elevated in patients with various cardiovascular conditions, including heart failure, myocardial infarction, and cardiomyopathy.
Function
ST2 is involved in the immune response and the development of fibrosis in the heart. It acts as a decoy receptor for interleukin-33 (IL-33), thereby modulating the effects of IL-33 on cardiomyocytes and fibroblasts in the heart. This modulation plays a critical role in the pathological remodeling of the heart that occurs in response to stress and injury.
Clinical Significance
Elevated levels of sST2 are associated with adverse outcomes in patients with heart failure and are predictive of mortality and hospitalization. The measurement of sST2 levels is used in conjunction with other biomarkers, such as NT-proBNP and troponin, to improve risk stratification and guide treatment decisions in patients with cardiovascular diseases. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recognize the prognostic value of sST2 in patients with acute and chronic heart failure.
Measurement
The concentration of sST2 in the blood can be measured using enzyme-linked immunosorbent assay (ELISA) kits. These tests are designed for use in clinical laboratories and provide a quantitative assessment of sST2 levels.
Limitations
While sST2 is a valuable biomarker for cardiovascular disease, it is not without limitations. Its levels can be influenced by factors other than heart disease, such as inflammation and renal function. Therefore, the interpretation of sST2 levels should be done in the context of a comprehensive clinical assessment.
Future Directions
Research is ongoing to further elucidate the role of ST2 in cardiovascular disease and to explore its potential as a therapeutic target. The development of drugs that modulate the ST2-IL-33 pathway could offer new avenues for the treatment of heart failure and other cardiovascular conditions.
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Contributors: Prab R. Tumpati, MD