Soluble form of suppression of tumorigenicity-2 predicts clinical stability of inpatients with community-acquired pneumonia

Yifeng Zeng, Mingshan Xue, Teng Zhang, Shixue Sun, Runpei Lin, Ning Li, Peiyan Zheng, Yingjie Zhen, Haisheng Hu, Xiaohua Douglas Zhang, Baoqing Sun

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The soluble form of the suppression of tumorigenicity-2 (sST2) is a biomarker for risk classification and prognosis of heart failure, and its production and secretion in the alveolar epithelium are significantly correlated with the inflammation-inducing in pulmonary diseases. However, the predictive value of sST2 in pulmonary disease had not been widely studied. This study investigated the potential value in prognosis and risk classification of sST2 in patients with community-acquired pneumonia. Clinical data of ninety-three CAP inpatients were retrieved and their sST2 and other clinical indices were studied. Cox regression models were constructed to probe the sST2’s predictive value for patients’ restoring clinical stability and its additive effect on pneumonia severity index and CURB-65 scores. Patients who did not reach clinical stability within the defined time (30 days from hospitalization) have had significantly higher levels of sST2 at admission (P < 0.05). In univariate and multivariate Cox regression analysis, a high sST2 level (≥72.8 ng/mL) was an independent reverse predictor of clinical stability (P < 0.05). The Cox regression model combined with sST2 and CURB-65 (AUC: 0.96) provided a more accurate risk classification than CURB-65 (AUC:0.89) alone (NRI: 1.18, IDI: 0.16, P < 0.05). The Cox regression model combined with sST2 and pneumonia severity index (AUC: 0.96) also provided a more accurate risk classification than pneumonia severity index (AUC:0.93) alone (NRI: 0.06; IDI: 0.06, P < 0.05). sST2 at admission can be used as an independent early prognostic indicator for CAP patients. Moreover, it can improve the predictive power of CURB-65 and pneumonia severity index score.

Original languageEnglish
Pages (from-to)2297-2306
Number of pages10
JournalExperimental Biology and Medicine
Issue number21
StatePublished - Nov 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Natural Science Foundation of China (Project No.: 81871736), Guangdong Science and Technology Fund (Project No.: 2020B1111300001), Guangzhou Institute of Respiratory Health Open Project (Funds provided by China Evergrande Group) (Project No.:2020GIRHHMS04), Science and Technology Project of Guangzhou (Project No.: 20181A011061). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

Publisher Copyright:
© 2021 by the Society for Experimental Biology and Medicine.


  • CURB-65
  • Tumorigenicity-2
  • classification
  • pneumonia
  • pneumonia severity index
  • prognosis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology (all)


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