Background Some occupational asthma patients have a high risk of poor prognosis, and early assessment and screening of the high-risk groups with poor prognosis are crucial.

Objective To evaluate the prognostic value of serum histone deacetylase 2 (HDAC2) and soluble suppression of tumorigenicity 2 (sST2) in occupational asthma patients.

Methods An occupational asthma group containing 100 occupational asthma patients admitted to Baodi District People's Hospital of Tianjin between March 2020 and March 2023 were divided into a mild group of 38 cases, a moderate group of 40 cases, and a severe group of 22 cases, and re-divided into a good prognosis group of 66 cases and a poor prognosis group of 34 cases. During the same period, 98 ordinary asthma patients were recruited as the ordinary asthma group and 98 healthy individuals as the healthy control group. A multivariate logistic regression analysis was performed to investigate the relationships of prognosis with HDAC2, sST2, patients separated from allergen after diagnosis, age, body mass index (BMI), gender, smoking history, years of work, family history of asthma, allergy history, good medication adherence, regular follow-up visits. Receiver operating characteristic (ROC) curve was used to evaluate potential predictive value of serum HDAC2 and sST2, and Z-test was used to compare the area under the curve (AUC).

Results The serum HDAC2 concentration (11.13±2.26) ng·L⁻¹ in the occupational asthma group was lower than that in the ordinary asthma group and the healthy control group (16.72±3.15), (22.75±4.92) ng·L⁻¹, while the sST2 concentration (16.64±3.47) ng·L⁻¹ in the occupational asthma group was lower than that in the ordinary asthma group and the healthy control group (12.49±2.31), (9.04±1.98) ng·L⁻¹ (F=256.623, 201.091; P<0.05). The serum HDAC2 concentration (7.60±1.67) ng·L⁻¹ in the severe group was lower than that in the moderate and the mild groups (10.02±2.35), (14.34±3.88) ng·L⁻¹, while the sST2 concentration (24.65±6.31) ng·L⁻¹ in the severe group was lower than that in the moderate and the mild groups (16.88±3.50), (11.75±3.09) ng·L⁻¹(F=41.731, 67.564; P<0.05). The serum HDAC2 and the proportion of patients separated from allergen after diagnosis in the poor prognosis group were lower than those in the good prognosis group (8.19±1.94) vs (12.64±3.29) ng·L⁻¹, 64.71% vs 93.94%, and the serum sST2 in the poor prognosis group was higher than that in the good prognosis group (21.67±5.86) vs (14.05±3.62) ng·L⁻¹ (t/χ²=7.253, 12.177, 8.020; P<0.05). HDAC2 and sST2 were associated with poor 6-month prognosis in the occupational asthma patients (P<0.05). The AUCs for predicting poor prognosis in the occupational asthma patients by serum HDAC2 and sST2 concentrations alone and in combination were 0.826, 0.838, and 0.902, respectively.

Conclusion The serum HDAC2 concentration decreases and the sST2 concentration increases in patients with occupational asthma, and these two indicators may have important predictive value for poor disease prognosis.