The value of joint detection of sTREM-1 and PCT in the early diagnosis of children with sepsis / 中国医学装备

Objective: To investigate the value of joint detection of soluble triggering receptor expresses on myeloid cells-1(sTREM-1) and procalcitonin (PCT) in the early diagnosis of children with sepsis. Methods: 78 children with sepsis were selected into the sepsis group, 23 children with common infection were selected into the normal infection group. In addition, 25 healthy children selected into the health control group. The levels of sTREM-1, PCT, and C reactive protein (CRP) among the three groups were compared, respectively. And then, the sepsis group were further divided into general sepsis subgroup (32 cases), severe sepsis subgroup (26 cases) and septic shock subgroup (20 cases) according to the degree of sepsis. The levels of sTREM-1, PCT and CRP among the three sepsis subgroups were compared. And the receiver operating characteristic (ROC) curve was adopted to analyze the value that diagnosed children with sepsis by using the three indicators. Results: The levels of sTREM-1, PCT and CRP of sepsis group were significantly higher than those of common infection group and health control group (t=22.071, t=21.508, t=17.870, t=55.167, t=52.070, t=30.359, P<0.05). The differences of sTREM-1 and PCT among various sepsis subgroups were significant (H=22.082, H=39.449, P<0.05), but the difference of CRP level between septic shock subgroup and severe sepsis subgroup was no significant. As the compared result of AUC of ROC of diagnosing sepsis, the AUC of sTREM-1 was maximum (0.88), and its 95% confidence interval (CI) was 0.78-0.98. At the optimum cutoff value of sTREM-1, the sensitivity and specificity were 83.33% and 68%, respectively, and they were higher than those of PCT and CRP, respectively. Besides, the cutoff values of sTREM-1 and PCT were used as standard to carry out joint diagnosis for children with sepsis, and the sensitivity and specificity were 91.03% and 64%, respectively, at this joint diagnosis. Conclusion: The joint detection of sTREM-1 and PCT has higher sensitivity in the early diagnosis of children with sepsis and it has a certain clinical application value.

Detection of sTREM-1 levels in gingival crevicular fluid of peri-implantitis / 口腔疾病防治

Objective @#To investigate the relationship between the level of the soluble triggering receptor expressed on myeloid cell (sTREM-1) in the gingival crevicular fluid (GCF) of individuals and peri-implantitis.@*Methods@#46 patients (75 implants) with different severities of peri-implantitis and 18 patients (75 implants) without peri-implantitis were selected in this study. The concentrations of sTREM-1 in GCF with different types of peri-implantitis were detected by enzyme-linked immunosorbent assay (ELISA). The peri-implantitis peroxidase depth (PPD), the distance from the shoulder of the implant to the bottom of the bony defect (DSB), the modified sulcus bleeding index (mSBI) and the modified plaque index (mPLI) were recorded. The correlation between PPD, DSB, mSBI, mPLI and sTREM-1 was analyzed. @*Results @#The concentrations of sTREM-1 in GCF in mild, moderate and severe peri-implantitis group were significantly higher than those in healthy group (P < 0.05). The concentrations of sTREM-1 in GCF in severe peri-implantitis group were significantly higher than those in mild and moderate group (P < 0.05). There was no significant difference in the concentration of sTREM-1 in GCF between mild peri-implantitis group and moderate group (P > 0.05). In addition, there was a significant positive correlation between the concentration of sTREM-1 and PPD, DSB, mSBI, mPLI.@*Conclusions @#The concentration of sTREM-1 in GCF is closely related to the severity of tissue inflammation around implant.

The new progress of sTREM-1 in the diagnosis and treatment of sepsis / 中国综合临床

The Strem-1 is a member of the immunoglobulin family,which is recently found to be closely associated with the inflammatory and a sensitive marker of the inflammatory response.Many pathogenic microorganisms infection can make sTREM-1 highly expressed,it is involved in the secretion of pro-inflammatory factors by the role of TOLL receptors,and played an important role in the development of sepsis.It is a more sensitive and reliable indicator in the diagnosis and monitoring of sepsis in recent years.It is necessary to study the characteristics and role of sTREM-1 in the development of sepsis,and it has important significance in preventing the occurrence of sepsis and reasonable treatment or prognosis evaluation.

Expression of sTREM-1 and other biomarkers in Candida albicans pneumonia in rabbits / 中国免疫学杂志

Objective:To identify a suitable biomarker for early diagnosis and prognosis of Candida albicans pneumonia ( CAP) ,we investigated the expression of several biomarkers,such as soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1),soluble hemoglobin-haptoglobin scavenger receptor (sCD163),C-reactive protein (CRP),and procalcitonin (PCT),in rabbits with CAP. Methods:A rabbit model was established after immunosuppression of 40 rabbits,randomly divided into 2 groups of 20 each. The experimental group received 1 ml injection of 5×107 cfu/ml C. albicans solution via percutaneous tracheal puncture,while the control group received normal saline. Rabbit blood samples were collected on days 2,3,4,5,6 and 9 post-inoculation and examined for levels of sTREM-1,sCD163,CRP,PCT,interleukin-6 (IL-6),IL-8,IL-10 and tumor necrosis factor-α (TNF-α). Other tests included routine blood examination,arterial blood gas test,chest thin-layer computed tomography on days 3 and 9 post-inoculation,lung tissue biopsy, and blood culture to confirm C. albicans infection. Results:The levels of sTREM-1,SCD163,PCT,and TNF-αwere higher in the exper-imental group as compared to control. Additionally,sTREM-1 and CRP indices showed an upward trend during 9 days of observation period in the experimental group,while others showed a short-term increase after inoculation and then declined gradually. Areas under the receiver operating characteristic curve for CAP diagnosis were calculated as 0. 882,0. 814,0. 685 and 0. 55 for sTREM-1,SCD163, PCT and CRP,respectively. Conclusion: The diagnostic value of biomarkers,sTREM-1 and SCD163,is superior to that of CRP and PCT in the diagnosis of CAP.

Plasma soluble triggering receptor expressed on myeloid cells-1 as a marker of sepsis: a meta-analysis / 中华急诊医学杂志

Objective To investigate the value of plasma soluble triggering receptor expressed on myeloid cells-1 as a diagnosis marker of sepsis.Methods Articles on plasma soluble triggering receptor expressed on myeloid cells-1 as a marker of sepsis which were public published in the PubMed,Ovid,Springer,Wanfang database from 1991-2012 were searched and conducted a meta-analysis by MetaDiSc and Stata.Results Seven articles were selected to the meta-analysis according to the inclusion criteria,of which cut-off values varied signicantly from studies.Due to the data heterogeneity (I2 ＞ 50％,P ＜0.05),random model was used to pool the effect sizes.The overall combined effect sizes:sensitivity =81％ (95％CI:0.76-0.86); specificity =81％ (95％ CI:0.76-0.86); DOR =30.03 (95％ CI:7.89-114.37) ; AUC of SROC =0.905 9; Q*-0.837 6.Deek' s funnel plot showed little publication bias.Conclusions Plasma soluble triggering receptor expressed on myeloid cells-1 may be a useful adjunctive tool for the diagnosis of sepsis.However,further studies are needed in order to identify the best cut-off value in the diagnosis of sepsis.

The diagnostic value and prognostic significance of plasma soluble triggering receptor-1 on myeloid cells-1 in patients with sepsis / 中华急诊医学杂志

ObjectiveTo investigate the diagnostic value and prognostic significance of plasma soluble triggering receptor-1 on myeloid cells ( sTREM-1 ) in patients with sepsis in the early stage.MethodsA total of 56 patients with systemic inflammatory response syndrome (SIRS) were enrolled for prospective and control study from May 2009 through July 2010. According to the criteria of sepsis set by SCCN/ESICM/ACCP/ATS/SIS in 2001, patients were divided into sepsis group ( n = 32), SIRS group (n = 24) . Meanwhile, 25 non-SIRS patients were enrolled in the control group. The sepsis group was further divided into two subgroups, namely survival subgroup and non-survival subgroup according to 28-day outcomes. The sTREM-1, procalcitonin (PCT), C-reactive protein (CRP), white blood cell count and neutrophil percentage count (NPC) were measured and APACHE Ⅱ scores were determined within 24 hours after admission. The correlation between sTREM-1 and APACHE Ⅱ score was analyzed. Quantitative data were analyzed by using F-test or Kruskal-Wallis test. ResultsThe plasma level of sTREM-1 in patients of sepsis group was significantly higher than that in SIRS group and control group [215. 1 (157.9 ～397.3) ng/L vs 103.6 (89.4 ～ 176.2) ng/L vs 33.6 (26.2 ～ 43.0) ng/L, P＜0. 05]. The plasma level of sTREM-1 in non-survival group was significantly higher than that in survival group[360.5 (262.2～434.5) ng/L vs 204. 1 (175.0～269.6) ng/L, P=0.002]. In sepsis group, the plasma level of sTREM-1 was positively correlated with APACHE Ⅱ score ( r, = 0. 426, P = 0. 032 ) The area under the ROC curve of sTREM-1 was 0. 935, larger than that of PCT and CRP. Conclusions Plasma sTREM-1 is a useful marker in diagnosis of sepsis at early stage. The increase in the level of sTREM-1 during the first 24 hours might be correlated with poor outcome of patients with sepsis.

Diagnostic role of soluble triggering receptor expressed on myeloid cell-1 in patients with sepsis / 世界急诊医学杂志（英文）

BACKGROUND: Biomarkers may be helpful in risk stratification and prediction of mortality in septic patients. This study aimed to investigate the diagnostic role of soluble triggering receptor expressed on myeloid cell-1(sTREM-1), procalcitonin (PCT), C-reactive protein (CRP) and other inflammatory markers in patients with sepsis. METHODS: A total of 56 patients with systemic inflammation response syndrome (SIRS) who had been admitted to the ICU department of the Second Hospital of Tianjin Medical University between May 2009 and July 2010 were enrolled. They were divided into a sepsis group (n=32) and a SIRS group (n=24). Twenty-five non-SIRS patients served as controls. The sepsis group was sub-divided into a survival group and a death group according to 28-day prognosis. The values of sTREM-1, PCT, CRP, white blood cell (WBC), and neutrophil count percentage (N) were measured. Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score were determined within 24 hours. The correlation between sTREM-1 and APACHE Ⅱ score was analyzed. Quantitative data were analyzed by the F test or the Kruskal-Wallis test. RESULTS: The plasma level of sTREM-1 in the sepsis group was significantly higher than that in the SIRS group and control group. The plasma level of sTREM-1 in the non-survival group was significantly higher than that in the survival group. In the sepsis group, the plasma sTREM-1 level was positively correlated with APACHE Ⅱ score (rs=0.426, P= 0.032). The area under the ROC curve of sTREM-1 was 0.935, larger than that of PCT and CRP. CONCLUSION: Plasma sTREM-1 is useful in the diagnosis of sepsis at early stage. The increased level of sTREM-1 during the first 24 hours may be correlated with poor outcome of patients with sepsis.

Biomarcadores en neumonías / Biomarkers in pneumonia

Las neumonías, tanto comunitarias como nosocomiales, constituyen una importante causa de morbimortalidad a nivel global y ocasionan además importantes costos sanitarios. Como en cualquier otro proceso infeccioso, una adecuada respuesta a la infección es un fenómeno complejo que requiere un apropiado y oportuno tratamiento antibiótico, así como una apropiada respuesta inflamatoria inicial para contener la proliferación y diseminación de los microorganismos, seguida por una respuesta antiinflamatoria compensatoria que restaure la homeostasis inicial. Recientes estudios han demostrado que una excesiva respuesta inflamatoria en sepsis y NAC severa puede asociarse con efectos deletéreos y peor pronóstico. Por otro lado, una exagerada respuesta antiinflamatoria puede tener efecto negativo en la resolución de la infección. Por lo tanto, una mejor comprensión de este delicado equilibrio proinflamatorio/antiinflamatorio y sus mediadores podrán ser de gran ayuda para valorar la presencia y gravedad de la neumonía así como su probable evolución. En estudios previos varios marcadores han sido ensayados: Proteína C reactiva (PCR), Procalcitonina (PCT), diversas interleuquinas (IL1, IL6, IL8 e IL10), factor de necrosis tumoral alfa (TNFalfa), etc., como marcadores de inflamación/infección, gravedad, fallo de tratamiento y pronóstico. La presente monografía tiene por objeto hacer una revisión sintética de la literatura reciente sobre el tema, tratando de explorar y objetivar fortalezas y debilidades de tales marcadores biológicos.

Community acquired and nosocomial pneumonia are considered a global health issue and a significant cause of morbility, mortality and important economic costs. As in other infectious diseases, an appropriate therapeutic response to the infection is a complex phenomenon that requires appropriate and timely antimicrobial treatment and acorrect initial inflammatory response to stop the microbial proliferation and dissemination, followed by an anti-inflammatory response to restore the initial homeostasis. Recently published studies have showed that exaggerated inflammatory response in sepsis and severe community acquired pneumonia may be associated with poorer outcomes. On the other hand, an exagerated inflammatory response may have a deleterious effect on the infection resolution. Consequently, a better understanding of the delicate balance inflammation/anti-inflammation and their mediators could be of great help to understand the presence and severity of pneumonia and even to predict its outcome. Several marker shave been used, including C-reactive protein (CRP), procalcitonin, several interleukines [IL1, IL6, IL8, IL10], tumor necrosis factor-alpha (TNF alfa), etc, as markers of inflammation /infection, severity, therapeutic failure, severity therapeutic failure and prognostic tool. This review was performed to summarize the observations of the more recent published data on this topic, trying to explore strengths and weaknesses of these markers.

sTREM -1:a new diagnostic marker of serious bacterial infection in neonate / 国际儿科学杂志

The triggering receptor expressed on myeloid cells (TREM) -1 is a recently identified molecule involved in the inflammatory response.It belongs to the immunoglobulin superfamily,it was reported that it has relation with inflammatory response mediated by several microbial components,besides its soluble form was observed and identified at significant levels in bacterial infection of neonate.So it may become a valuable diagnostic marker of serious bacterial infection in neonate.