Soluble triggering receptor expressed on myeloid cells 1 as an anti-inflammatory mediator in sepsis.
OBJECTIVE
To define the significance of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the septic cascade by comparing its kinetics to those of other proinflammatory mediators and of interleukin (IL) 10.


METHODS
Prospective study in a tertiary unit.


METHODS
Blood was sampled from 90 patients with septic syndrome due to ventilator-associated pneumonia for 7 days after the appearance of symptoms. Concentrations of tumor necrosis factor (TNF) alpha, IL-6, IL-8, IL-10, and sTREM-1 were determined by enzyme-linked immunosorbent assay.


RESULTS
Serum levels of TNFalpha, IL-6, IL-10, and sTREM-1 were higher in nonsurvivors than in survivors; similar differences were not found for IL-8. Positive correlations were found between the ratios IL-10/TNFalpha and sTREM-1/TNFalpha, between IL-10/IL-6 and sTREM-1/IL-6, and between IL-10/IL-8 and sTREM-1/IL-8. Median values of IL-10/TNFalpha upon presentation of sepsis, severe sepsis, and septic shock were 3.21, 2.16, and 2.86, respectively (NS). Respective values for sTREM-1/TNFalpha were 21.28, 7.33, and 27.78 (p=0.047 between sepsis and severe sepsis, p=0.003 between severe sepsis and septic shock).


CONCLUSIONS
sTREM-1 follows the kinetics of IL-10 and should therefore be considered an anti-inflammatory mediator in sepsis. Decreased ratios of sTREM-1/TNFalpha might determine transition from sepsis to severe sepsis and from severe sepsis to septic shock.
Giamarellos-Bourboulis
Evangelos J
EJ
Fourth Department of Internal Medicine, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece. giamarel@ath.forthnet.gr.
Zakynthinos
Spyridon
S
First Department of Critical Care, Evangelismos Hospital, 17 Ipsilantou Str., 11526, Athens, Greece.
Baziaka
Fotini
F
Fourth Department of Internal Medicine, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece.
Papadomichelakis
Evangelos
E
Second Department of Critical Care, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece.
Virtzili
Simona
S
First Department of Critical Care, Evangelismos Hospital, 17 Ipsilantou Str., 11526, Athens, Greece.
Koutoukas
Pantelis
P
Fourth Department of Internal Medicine, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece.
Armaganidis
Apostolos
A
Second Department of Critical Care, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece.
Giamarellou
Helen
H
Fourth Department of Internal Medicine, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece.
Roussos
Charis
C
First Department of Critical Care, Evangelismos Hospital, 17 Ipsilantou Str., 11526, Athens, Greece.
D000368:Aged; D016207:Cytokines / Q000276:immunology / Q000378:metabolism; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D008297:Male; D008562:Membrane Glycoproteins / Q000276:immunology* / Q000378:metabolism*; D008875:Middle Aged; D022423:Myeloid Cells / Q000276:immunology* / Q000378:metabolism*; D011446:Prospective Studies; D011971:Receptors, Immunologic / Q000276:immunology* / Q000378:metabolism*; D018805:Sepsis / Q000276:immunology* / Q000378:metabolism*; D018709:Statistics, Nonparametric; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10