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Published on: December 9, 2022
Soluble triggering receptor expressed on myeloid cells 1 and the diagnosis of sepsis
Mitra Barati1, Farshid Rahimi Bashar, Reza Shahrami
1Pediatric Infectious Diseases Research Centre, Iran University of Medical Science, Tehran, Iran. mitra_baraty@yahoo.com
Purpose:
Early diagnosis and assessment of the systemic inflammatory response to infection are difficult with usual markers (fever, leukocytosis, C-reactive protein [CRP]). Triggering receptor expressed on myeloid cells-1 (TREM-1) expression on phagocytes is up-regulated by microbial products. We studied the ability of soluble TREM-1 (sTREM-1) to identify patients with sepsis.
Materials And Methods:
Plasma samples were obtained on intensive care unit admission from patients with systemic inflammatory response syndrome for sTREM-1 measurement.
Results:
Soluble TREM-1, CRP concentrations and erythrocyte sedimentation rate (ESR) were higher in the sepsis group (n = 52) than in the non-infectious systemic inflammatory response syndrome group (n = 43; P = .00, .02, and .001, respectively). Soluble TREM-1, CRP concentrations, white blood cell count and ESR were higher in the sepsis group than in the non SIRS group (n = 37; P = .04, .00, .01, and .00, respectively). In a receiver-operating characteristic curve analysis, ESR, CRP and sTREM-1 had an area under the curve larger than 0.65 (P = .00), in distinguishing between septic and non-infectious SIRS patients. CRP, ESR, sTREM-1 had a sensitivity of 60%, 70% and 70% and a specificity of 60%, 69% and, 60% respectively in diagnosing infection in SIRS.
Conclusion:
C-reactive protein and ESR performed better than sTREM-1 and white blood cell count in diagnosing infection.
Insights
Diagnosing sepsis is challenging with standard markers. While soluble TREM-1 (sTREM-1) shows promise, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are more effective for infection diagnosis in SIRS patients.
Area of Science:
- Critical Care Medicine
- Immunology
- Infectious Diseases
Background:
- Early diagnosis of sepsis and systemic inflammatory response syndrome (SIRS) is often difficult using conventional markers like fever, leukocytosis, and C-reactive protein (CRP).
- Triggering receptor expressed on myeloid cells-1 (TREM-1) is upregulated on phagocytes during infection, making its soluble form (sTREM-1) a potential biomarker.
Purpose of the Study:
- To evaluate the diagnostic utility of soluble TREM-1 (sTREM-1) in identifying patients with sepsis.
- To compare the effectiveness of sTREM-1 against established markers such as CRP and erythrocyte sedimentation rate (ESR) in diagnosing infection.
Main Methods:
- Plasma samples were collected from intensive care unit (ICU) patients upon admission.
- Measurements included sTREM-1, CRP, white blood cell count, and ESR.
- Receiver-operating characteristic (ROC) curve analysis was used to assess diagnostic performance.
Main Results:
- sTREM-1, CRP, and ESR levels were significantly higher in sepsis patients compared to non-infectious SIRS and non-SIRS groups (P < .05).
- ROC analysis indicated that ESR, CRP, and sTREM-1 all had areas under the curve greater than 0.65 for distinguishing sepsis.
- CRP and ESR demonstrated higher sensitivity and specificity in diagnosing infection compared to sTREM-1 and white blood cell count.
Conclusions:
- Traditional markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) appear more effective than soluble TREM-1 (sTREM-1) for diagnosing infection in patients with systemic inflammatory response syndrome (SIRS).
- Further research may be needed to fully elucidate the role of sTREM-1 in sepsis diagnostics.
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