Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2021; 27(38): 6489-6500
Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6489
Serum soluble suppression of tumorigenicity 2 as a novel inflammatory marker predicts the severity of acute pancreatitis
Yan Zhang, Bo Cheng, Zhong-Wei Wu, Zong-Chao Cui, Yao-Dong Song, San-Yang Chen, Yan-Na Liu, Chang-Ju Zhu
Yan Zhang, Bo Cheng, Zhong-Wei Wu, Zong-Chao Cui, Yao-Dong Song, San-Yang Chen, Yan-Na Liu, Chang-Ju Zhu, Department of Emergency, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Zhu CJ conceived and designed the study; Zhang Y, Cheng B, Liu YN and Wang QF performed the research; Wu ZW contributed the data acquisition; Zhang Y and Cui ZC conducted data analysis/interpretation; Song YD contributed statistical analysis; Zhang Y and Chen SY wrote the manuscript; All authors have read and approved the final manuscript.
Supported by Henan Province Education Department for Henan Province University Key Scientific Research Project, No. 20A320018 and No. 20A320064.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Zhengzhou University Institutional Review Board [(Approval No. 2018-KY-140)].
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have no potential conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at zhuchangju98@163.com. No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang-Ju Zhu, PhD, Chief Doctor, Chief Physician, Director, Doctor, Professor, Department of Emergency, the First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou 450052, Henan Province, China. zhuchangju98@163.com
Received: April 4, 2021
Peer-review started: April 4, 2021
First decision: May 27, 2021
Revised: June 10, 2021
Accepted: August 27, 2021
Article in press: August 27, 2021
Published online: October 14, 2021
Processing time: 190 Days and 14.3 Hours
ARTICLE HIGHLIGHTS
Research background

The clinical severity of acute pancreatitis (AP) is related to its prognosis. Excessive activation of inflammatory cells and their cytokines is one of the main mechanisms of pathogenesis of AP. Research on changes in inflammatory mediators in patients with different clinical severity of AP is important clinically. The interleukin (IL)-33/ST2L functional pathway is involved in the pathological process of AP. Soluble suppression of tumorigenicity 2 (sST2) is a secreted form of the ST2 receptor and acts as a decoy receptor for IL-33. In this study, we investigated whether the sST2 could serve as a novel inflammatory marker predicting the severity of acute pancreatitis.

Research motivation

In this study, the authors focused on the function of sST2 in predicting the severity of AP. The key issue to be solved is the association between IL-33/ST2L pathway and AP. The significance of solving these problems may constitute a new therapeutic target for regulating immune activation during the AP inflammatory storm.

Research objectives

The objective of this study was to investigate the role of sST2 in AP.

Research methods

The authors assessed the association between sST2 and severity of AP in 123 patients enrolled in this study. The serum levels of sST2, C-reactive protein (CRP) and Th1- and Th2-related cytokines interferon (IFN)-γ, tumor necrosis factor (TNF)-α ,IL-2, IL-4, IL-5 and IL-13 were measured by highly sensitive ELISA and the severity of AP patients was evaluated by the 2012 Atlanta Classification Criteria.

Research results

The serum sST2 Level was significantly increased in AP patients and significantly elevated in severe acute pancreatitis (SAP) patients compared to moderate severe acute pancreatitis and mild acute pancreatitis patients. The cutoff point of sST2 at 1190pg/mL was associated with SAP.

Research conclusions

This study suggests that sST2 may be used as a novel inflammatory marker in predicting the severity of acute pancreatitis and that sST2 might regulate the function and differentiation of IL-33/ST2L mediated Th1 and Th2 lymphocytes in the homeostasis of acute pancreatitis.

Research perspectives

It is necessary to determine the long-term predictive value of sST2 for the prognosis of AP in subsequent longitudinal studies. Additionally, the role of IL-33/ST2L in acute pancreatitis needs to be further verified in both in vivo and in vitro experiments.