Triggering receptors expressed on myeloid cells in pulmonary aspiration syndromes.
OBJECTIVE
To investigate the potential role of serum and alveolar soluble triggering receptor expressed on myeloid cells (sTREM-1) as a biological marker of pulmonary aspiration syndromes.


METHODS
Prospective cohort study.


METHODS
University-affiliated intensive care unit.


METHODS
Seventy-five patients with pulmonary aspiration and 13 controls receiving mechanical ventilation.


METHODS
Blood and bronchoalveolar lavage (BAL) fluid samples were collected on enrollment. Soluble TREM-1 levels were measured by an enzyme-linked immunosorbent assay.


RESULTS
Thirty-eight of 75 participants had documented BAL culture-positive pulmonary aspiration. While circulating levels of sTREM-1 were comparable between those with aspiration syndromes (19.81 +/- 12.09 pg/ml) and controls (15.96 +/- 11.16 pg/ml) (p=0.27), the alveolar levels of sTREM-1 were higher in patients with culture-positive pulmonary aspiration (344.41 +/- 152.82 pg/ml) compared with those culture-negative pulmonary aspiration (142.76 +/- 89.88 pg/ml; p < 0.001). A cut-off value of 250 pg/ml for alveolar sTREM-1 achieved a sensitivity of 65.8% (95% CI 48.6-80.4) and a specificity of 91.9% (95% CI 78.1-98.2) with an area under the curve of 0.87 (95% CI 0.78-0.94).


CONCLUSIONS
Alveolar sTREM-1 levels can be a potential biomarker for distinguishing BAL culture-positive from BAL culture-negative pulmonary aspiration.
El Solh
Ali A
AA
Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA. solh@buffalo.edu
Akinnusi
Morohunfolu E
ME
Peter
Misha
M
Berim
Ilya
I
Schultz
Marcus J
MJ
Pineda
Lilibeth
L
D015415:Biomarkers / Q000378:metabolism*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism*; D008875:Middle Aged; D022423:Myeloid Cells / Q000378:metabolism*; D011014:Pneumonia / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D011015:Pneumonia, Aspiration / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D011446:Prospective Studies; D012372:ROC Curve; D011971:Receptors, Immunologic / Q000378:metabolism*; D012121:Respiration, Artificial; D018709:Statistics, Nonparametric; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
D015415:Biomarkers; D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1