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Soluble TREM2 Is Elevated in Pediatric Patients with Anti-NMDAR Encephalitis

Anna Zhou1, Changhong Ren1, Ji Zhou1

  • 1Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

Journal of Clinical Medicine
|February 13, 2026
PubMed

Insights

Soluble Triggering Receptor Expressed on Myeloid cells 2 (sTREM2) in cerebrospinal fluid (CSF) is a promising biomarker for diagnosing and predicting outcomes in pediatric anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Higher CSF sTREM2 levels indicate greater neuroinflammation and poorer prognosis.

Area of Science:

  • Neuroimmunology
  • Biomarker Discovery
  • Pediatric Neurology

Background:

  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder in children.
  • Accurate diagnostic and prognostic biomarkers are critical for effective management of pediatric anti-NMDAR encephalitis.
  • Soluble Triggering Receptor Expressed on Myeloid cells 2 (sTREM2) is being investigated for its role in neuroinflammation.

Purpose of the Study:

  • To evaluate soluble Triggering Receptor Expressed on Myeloid cells 2 (sTREM2) in cerebrospinal fluid (CSF) and serum as diagnostic and prognostic biomarkers in pediatric anti-NMDAR encephalitis.
  • To assess the correlation between sTREM2 levels and disease severity and outcomes.

Main Methods:

  • The study involved 21 pediatric patients with anti-NMDAR encephalitis and 27 controls with non-inflammatory neurological disorders (OND).
  • CSF and serum samples were analyzed for sTREM2 levels using enzyme-linked immunosorbent assay (ELISA).
  • Statistical analyses included Mann-Whitney U test and ROC curve analysis to determine diagnostic and prognostic value.

Main Results:

  • Children with anti-NMDAR encephalitis exhibited significantly higher CSF and serum sTREM2 levels compared to controls (p < 0.001).
  • CSF sTREM2 levels positively correlated with disease severity (mRS scores) and negatively with neurological function (GCS scores).
  • CSF sTREM2 demonstrated high diagnostic accuracy (AUC = 0.887), with serum sTREM2 also showing significant accuracy (AUC = 0.848).
  • Lower CSF sTREM2 levels were associated with better patient prognoses (p = 0.029).

Conclusions:

  • Elevated CSF sTREM2 levels are linked to increased neuroinflammation and adverse clinical outcomes in pediatric anti-NMDAR encephalitis.
  • CSF sTREM2 shows potential as a valuable biomarker for diagnosing pediatric anti-NMDAR encephalitis.
  • sTREM2 may aid in predicting prognosis and guiding treatment strategies for affected children.

Keywords:
NMDARETREM2pediatric

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