Department of General Surgery, Division of Vascular Surgery, University Hospital Vienna, Medical University of Vienna, 1090 Vienna, Austria.
Department of Laboratory Medicine, University Hospital Vienna, Medical University of Vienna, 1090 Vienna, Austria.
Int J Mol Sci. 2022 Aug 24;23(17):9598. doi: 10.3390/ijms23179598.
The maximal aortic diameter is the only clinically applied predictor of abdominal aortic aneurysm (AAA) progression and indicator for surgical repair. Circulating biomarkers resulting from AAA pathogenesis are attractive candidates for the diagnosis and prognosis of aneurysmal disease. Due to the reported role of interleukin 33 in AAA development, we investigated the corresponding circulating receptor molecules of soluble suppression of tumorigenesis 2 (sST2) in AAA patients regarding their marker potential in diagnosis and prognosis. We conducted a single-center retrospective cohort study in a diagnostic setting, measuring the circulating serum sST2 protein levels of 47 AAA patients under surveillance, matched with 25 peripheral artery disease (PAD) patients and 25 healthy controls. In a prognostic setting, we analyzed the longitudinal monitoring data of 50 monitored AAA patients. Slow versus fast AAA progression was defined as a <2 or ≥2 mm increase in AAA diameter over 6 months and a <4 or ≥4 mm increase over 12 months. Additionally, the association of circulating serum sST2 and AAA growth was investigated using a specifically tailored log-linear mixed model. Serum sST2 concentrations were significantly increased in AAA patients compared with healthy individuals: the median of AAA patient cohort was 112.72 ng/mL (p = 0.025) and that of AAA patient cohort 2 was 14.32 ng/mL (p = 0.039) versus healthy controls (8.82 ng/mL). Likewise, PAD patients showed significantly elevated sST2 protein levels compared with healthy controls (the median was 12.10 ng/mL; p = 0.048) but similar concentrations to AAA patients. Additionally, sST2 protein levels were found to be unsuited to identifying fast AAA progression over short-term periods of 6 or 12 months, which was confirmed by a log-linear mixed model. In conclusion, the significantly elevated protein levels of sST2 detected in patients with vascular disease may be useful in the early diagnosis of AAA but cannot distinguish between AAA and PAD or predict AAA progression.
最大主动脉直径是唯一用于预测腹主动脉瘤（AAA）进展和指示手术修复的临床应用预测因子。AAA 发病机制产生的循环生物标志物是动脉瘤疾病诊断和预后的有吸引力的候选物。由于白细胞介素 33 在 AAA 发展中的作用，我们研究了 AAA 患者中可溶性肿瘤抑制物 2（sST2）的相应循环受体分子在诊断和预后方面的标记潜力。我们在诊断环境中进行了一项单中心回顾性队列研究，测量了 47 名接受监测的 AAA 患者的循环血清 sST2 蛋白水平，与 25 名外周动脉疾病（PAD）患者和 25 名健康对照相匹配。在预后环境中，我们分析了 50 名监测 AAA 患者的纵向监测数据。慢进展与快进展的定义为 6 个月内 AAA 直径增加<2 或≥2mm，12 个月内增加<4 或≥4mm。此外，还使用专门设计的对数线性混合模型研究了循环血清 sST2 与 AAA 生长的关系。与健康个体相比，AAA 患者的血清 sST2 浓度显着升高：患者队列的中位数为 112.72ng/mL（p=0.025），患者队列 2 的中位数为 14.32ng/mL（p=0.039），而健康对照组的中位数为 8.82ng/mL。同样，与健康对照组相比，PAD 患者的 sST2 蛋白水平显着升高（中位数为 12.10ng/mL；p=0.048），但与 AAA 患者相似。此外，通过对数线性混合模型证实，sST2 蛋白水平不适合在 6 或 12 个月的短期期间识别快速 AAA 进展。总之，在血管疾病患者中检测到的 sST2 蛋白水平显着升高可能有助于早期诊断 AAA，但不能区分 AAA 和 PAD，也不能预测 AAA 进展。
