{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T18:12:34Z","timestamp":1778523154921,"version":"3.51.4"},"reference-count":37,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey","award":["47"],"award-info":[{"award-number":["47"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Asthma is a heterogeneous chronic inflammatory airway disease characterized by recurrent exacerbations and variable airflow limitation. Epithelial-derived alarmins, particularly interleukin-33 (IL-33) and its receptor ST2, play key roles in type 2 inflammation. The soluble form of ST2 (sST2) acts as a decoy receptor regulating IL-33 signaling. Vitamin D is an important immunomodulator influencing airway inflammation, but its interaction with the IL-33\/ST2 pathway remains unclear. Objective: To evaluate the association between serum IL-33, sST2, and 25-hydroxyvitamin D [25(OH)D] levels with asthma severity and exacerbation status, and to assess their potential as clinical biomarkers. Methods: This study enrolled 52 adult asthma patients (27 experiencing exacerbation and 25 in remission) and 28 healthy controls. Serum levels of IL-33 and sST2 were measured using enzyme-linked immunosorbent assays, while 25(OH)D concentrations were determined via electrochemiluminescence immunoassay. Results: Serum sST2 levels were significantly higher and 25(OH)D levels significantly lower in asthma patients compared with controls (p &lt; 0.000 for both). Serum IL-33 levels did not differ significantly between groups (p &gt; 0.05). During exacerbation, sST2 levels were markedly elevated compared with remission (p &lt; 0.001), whereas vitamin D levels were significantly reduced (p = 0.038). A significant negative correlation was identified between sST2 and 25(OH)D (r = \u22120.333, p = 0.016). Conclusions: The presence of asthma and the severity of exacerbations are associated with elevated circulating sST2 levels and reduced vitamin D levels. These findings suggest a regulatory interaction between vitamin D and the IL-33\/ST2 axis in airway inflammation and indicate that targeting this axis could be a potential therapeutic strategy.<\/jats:p>","DOI":"10.3390\/jcm15103663","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:17:42Z","timestamp":1778519862000},"page":"3663","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Significance of the IL-33\/sST2 Axis and Vitamin D Status in the Assessment of Disease Severity and Exacerbation Risk in Asthma: A Prospective Controlled Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7932-3336","authenticated-orcid":false,"given":"Mine","family":"Huryasar Eskici","sequence":"first","affiliation":[{"name":"Department of Clinical Biochemistry, Prof. Dr. Cemil Tascioglu City Hospital, 34384 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilgun","family":"Basaran","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Prof. Dr. Cemil Tascioglu City Hospital, 34384 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukaddes","family":"Goker","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Prof. Dr. Cemil Tascioglu City Hospital, 34384 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Buse","family":"Akyol","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Prof. Dr. Cemil Tascioglu City Hospital, 34384 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulcan","family":"Guntas","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, School of Medicine, Atlas University, 34403 Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"ref_1","unstructured":"(2026, January 02). 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