Related Experiment Video
Updated: May 22, 2025
Expression of Exogenous Cytokine in Patient-derived Xenografts via Injection with a Cytokine-transduced Stromal Cell Line
Published on: May 10, 2017
Surface triggering receptor expressed on myeloid cells-1 (sTREM1) in critically ill children: a prospective
Elsaeed Rashad Fouda1, Sara Hosny Abd Elghany1, Thoria Ahmed Omar2
1Department of Pediatrics, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Insights
Critically ill children in the pediatric intensive care unit (PICU) have significantly higher levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM1). Elevated sTREM1 may serve as a crucial prognostic indicator in pediatric critical care.
Area of Science:
- Pediatric Critical Care Medicine
- Immunology
- Biomarker Research
Background:
- Early detection of risk factors in critically ill children improves outcomes.
- Soluble triggering receptor expressed on myeloid cells-1 (sTREM1) is a potential prognostic marker with limited data in pediatric intensive care.
- Understanding novel biomarkers is crucial for managing critically ill pediatric patients.
Purpose of the Study:
- To evaluate the level of sTREM1 in critically ill children.
- To assess the prognostic role of sTREM1 in pediatric intensive care unit (PICU) patients.
Main Methods:
- Prospective observational study in a tertiary care hospital.
- Enrolled 70 critically ill children and 50 healthy controls.
- Measured sTREM1 levels on PICU admission, excluding immunocompromised patients.
Main Results:
- Significantly higher sTREM1 levels were observed in critically ill children (850 pg/mL IQR 510.0-1375.0) compared to healthy controls (67.5 pg/mL IQR 40.0-85.0).
- The study assessed sTREM1 levels as a primary outcome.
- Secondary outcomes included mortality, sepsis, mechanical ventilation, and PICU stay.
Conclusions:
- Critically ill children exhibit markedly elevated sTREM1 levels compared to healthy controls.
- sTREM1 warrants further investigation as a prognostic biomarker in pediatric critical care.
- This finding highlights the potential of sTREM1 in identifying high-risk pediatric patients.
Background:
In children admitted to the pediatric intensive care unit (PICU), early detection of risk factors and alarming indicators improves the prognosis and may even save lives. Several prognostic markers and scores have been studied in children who are seriously ill. Recently, surface triggering receptor expressed on myeloid cells-1 (sTREM1) has been studied in many infectious and non-infectious settings; however, there is little information on critically ill children. Our aim is to evaluate the sTREM1 level in critically ill children and assess its prognostic role.
Method:
A prospective observational study was conducted in a tertiary care hospital. 70 critically ill children and 50 healthy controls were enrolled in the study. Demographic, clinical, and laboratory data were obtained. sTREM1 level was assessed on admission to the PICU. Patients with conditions affecting immunity were excluded. The primary outcome was to assess the level of sTREM1 in both patients and controls. Secondary outcomes were mortality, morbidities as sepsis, need for mechanical ventilation, and PICU stay.
Results:
The level of sTREM1 was significantly higher in patients than in controls (850 pg/mL, interquartile range [IQR] 510.0- 1375.0 vs. 67.5 pg/mL, IQR 40.0- 85.0; p<0.001). sTREM1 level was significantly higher in non-survivors (p <0.001), patients with sepsis (p = 0.0028), and in patients who were mechanically ventilated (p <0.001). sTREM1 level had a significant positive correlation with the duration of PICU stay (r=0.624, p <0.001), and the duration of mechanical ventilation (r=0.527, p <0.001). On ROC curve analysis, sTREM1 was the most significant diagnostic marker compared to lactate and procalcitonin, at a cutoff value of 680 pg/mL, with a sensitivity of 93.8% and a specificity of 61.1% with an area under the curve of 0.862.
Conclusion:
In critically ill children, sTREM1 has prognostic and diagnostic values. There were associations between sTREM1 and the severity of the disease. To validate our results, subgroup analysis and multicenter trials are necessary.
