Abstract
Increased soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) levels have been reported in patients with sepsis. We tested the hypotheses that serum sTREM-1 levels increase in the early phase of sepsis and decrease after sepsis under appropriate treatment and that sTREM-1 levels can predict therapeutic outcomes. One hundred and fifty-five patients prospectively underwent blood samples including biochemical data, sTREM-1, and biomarkers on endothelial dysfunction as well as clinical severity index examinations. Blood samples from Days 1, 4, and 7 after admission were checked. For comparison, 50 healthy subjects were selected as healthy control. Those patients who had sepsis had significantly higher sTREM-1 levels than those of healthy control. sTREM-1 levels positively correlated with biomarkers for endothelial dysfunction (ICAM-1, VCAM-1, and E-selectin) and lactate level as well as clinical severity index (maximum 24 h APACHE score and Sequential Organ Failure Assessment (SOFA) score) upon admission. sTREM-1 concentrations were significantly higher from Day 1 to Day 7 in the non-survivors than in the survivors. A stepwise logistic regression analysis showed only sTREM-1 level and maximum 24 h SOFA score upon admission were significantly associated with fatality. Area under the receiver operating characteristic curve analysis for the diagnostic accuracy of sTREM-1 in sepsis-related fatality gave a value of 0.726, with a cutoff value of 384.6 pg/mL (sensitivity = 80.8% and specificity = 61.5%). sTREM-1 level may be valuable in auxiliary diagnosis, and it can serve as a useful biomarker as a screening service and follow-up therapeutic outcomes in sepsis.
Highlights
Despite the advent of new antimicrobial drugs and modern equipment, sepsis remains one of the major causes of fatality, with a fatality rate of 20–60% [1]
In early pro-inflammatory processes of sepsis, biomarkers involved in the pro-inflammatory response of the immune system (e.g., triggering receptor expressed on myeloid cells 1 (TREM-1)), by way of regulating the neutrophil inflammatory responses, have an important effect on the acute host response to sepsis [4,5,6,7]
We aimed to study the relationship between serial sTREM-1 levels and therapeutic outcome in patients with sepsis
Summary
Despite the advent of new antimicrobial drugs and modern equipment, sepsis remains one of the major causes of fatality, with a fatality rate of 20–60% [1]. Acute infection triggers an overwhelming proinflammatory host response, leading to uncoordinated upregulation and downregulation of several different inflammatory pathways. It results in a dysregulated inflammatory response, and leads to organ dysfunction and failure [3]. In early pro-inflammatory processes of sepsis, biomarkers involved in the pro-inflammatory response of the immune system (e.g., triggering receptor expressed on myeloid cells 1 (TREM-1)), by way of regulating the neutrophil inflammatory responses, have an important effect on the acute host response to sepsis [4,5,6,7]. If blood samples taken from each patient could follow a standard pattern and temporal relationship rather than consisting of only one blood sample on admission, it would reduce variability and improve diagnostic accuracy to predict the prognoses
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
