ST2 protein in heart disease: from discovery to mechanisms and prognostic value.

Biomarkers aid in diagnosis by providing important information for the clinical assessment of patients that is not achieved by other means. This article focuses on the use of soluble ST2 as a biomarker in cardiovascular disease. Soluble ST2 is a secreted receptor belonging to the IL-1 receptor family that regulates inflammation and immunity. Recent studies have shown that soluble ST2 is a decoy receptor that disrupts the interaction of IL-33 with the full-length ST2L receptor. The rapidly evolving and expanding literature on ST2 and its ligand reveal emerging roles for this system in the regulation of inflammation in a variety of diseases. Elevated ST2 levels have been detected in cardiovascular diseases and levels provide useful prognostic information in many, but not all, of these diseases, which will be discussed here. Additional studies demonstrating elevated soluble ST2 levels in other human diseases will also be discussed.