Levels of soluble triggering receptor expressed on myeloid cells 1 in infectious exacerbations of chronic obstructive
Gernot Rohde1, Markus P Radsak, Irmgard Borg
1Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands. g.rohde@mumc.nl
Background:
Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) is an activating receptor on inflammatory cells upregulated by microbial products. Elevated levels of sTREM-1 have been associated with the diagnosis and prognosis of patients with sepsis, severe pneumonia and chronic obstructive pulmonary disease (COPD).
Objectives:
The aim of this study was to define the role of sTREM-1 in acute exacerbations of COPD (AE-COPD) and to investigate the ability of sTREM-1 to differentiate between infectious triggers of AE-COPD.
Methods:
Smokers without COPD (SM), patients with stable COPD (sCOPD) and patients with AE-COPD were prospectively recruited. sTREM-1 levels were determined by ELISA in serum. Potentially pathogenic bacteria were analyzed by sputum culture, and polymerase chain reaction was used to determine the presence of respiratory viruses.
Results:
One hundred and ninety-five subjects were included: 64 sCOPD patients, 118 AE-COPD patients and 13 SM. In 62 (52.6%) AE-COPD patients, a respiratory pathogen was detected. Serum levels of sTREM-1 were barely detectable in SM but were significantly increased in patients with sCOPD [97.5 (interquartile value 76.6) pg/ml] and AE-COPD [110.9 (98.5) pg/ml; p<0.001]. There was no significant difference in sTREM-1 between sCOPD and AE-COPD (p=0.277). However, in AE-COPD, sTREM-1 was significantly lower in patients with virus detection [87.5 (97.3) pg/ml] compared to those without [120.3 (99.7) pg/ml; p=0.015]. No difference was found in AE-COPD patients with or without bacterial detection.
Conclusions:
The present study shows an increase in sTREM-1 in patients with COPD compared to SM but not in AE-COPD compared to sCOPD. Viral exacerbations showed significantly lower sTREM-1 levels than non-viral exacerbations.
Insights
Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) is elevated in COPD patients but not specifically in acute exacerbations. Viral infections during exacerbations are associated with lower sTREM-1 levels.
Area of Science:
- Immunology
- Respiratory Medicine
- Biomarker Research
Background:
- Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) is an inflammatory cell receptor upregulated by microbial products.
- Elevated sTREM-1 levels are linked to sepsis, severe pneumonia, and chronic obstructive pulmonary disease (COPD).
Purpose of the Study:
- To determine the role of sTREM-1 in acute exacerbations of COPD (AE-COPD).
- To assess sTREM-1's ability to differentiate between infectious triggers in AE-COPD.
Main Methods:
- Prospective recruitment of smokers without COPD (SM), stable COPD (sCOPD) patients, and AE-COPD patients.
- Quantification of serum sTREM-1 levels using ELISA.
- Detection of bacterial pathogens via sputum culture and respiratory viruses via PCR.
Main Results:
- sTREM-1 levels were significantly higher in sCOPD and AE-COPD patients compared to SM.
- No significant difference in sTREM-1 was observed between sCOPD and AE-COPD patients.
- AE-COPD patients with viral detection showed significantly lower sTREM-1 levels than those without viral detection.
Conclusions:
- sTREM-1 is elevated in COPD patients but not specifically during acute exacerbations compared to stable COPD.
- Lower sTREM-1 levels in AE-COPD are associated with viral infections, suggesting a potential role in differentiating exacerbation causes.
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