Białko ST-2 — nowy biomarker w niewydolności serca

Natriuretic peptides remain a gold predictive markers in heart failure (HF) patients. However, currently new molecule ST-2 protein has emerged as marker of inflammation, fibrosis and cardiac stress. ST-2 occurs in two isoforms: transmembrane (ST2L) and circulating or soluble (sST-2). ST-2 binds with IL-33 and this IL-33/ST2 system is upregulated in cells in response to mechanical stimulation or injury. In experimental models, the interaction of IL-33 with the membrane ST-2 exerts beneficial effects in the myocardium. Inversely, sST-2 by sequestering IL-33, antagonizes the cardioprotective effects of IL-33/ST2L interaction. In patient with acute decompensated HF, sST-2 concentration are considerd as prognostic for short- and long-term risk of major adverse cardiovascular events. sST-2 concentrations are also related to the risk of all-cause death, cardiovascular death or to HF in patient with undifferentiated chest pain as well as in those with confirmed coronary artery disease. ST-2 measurement is now a clinically useful tool also for risk stratification of patient with chronic HF. The information obtained from ST-2 levels is complementary to that obtained from natriuretic peptides. ST-2 protein seems to be very promising biomarker, however complete recognition of its diagnostic and prognostic value will require further research.