Evidence for the participation of soluble triggering receptor expressed on myeloid cells-1 in the systemic inflammatory response syndrome after multiple trauma.
BACKGROUND
Based on the implication of soluble triggering receptor expressed on myeloid cells (sTREM-1) in the septic cascade, it was investigated whether it participates or not in posttraumatic systemic inflammatory response syndrome (SIRS).


METHODS
Blood was sampled on days 1, 4, 7, and 15 from 69 patients with SIRS after multiple injuries and upon presentation of a septic complication. Concentrations of sTREM-1, tumor necrosis factor-alpha (TNFalpha), interleukin (IL)-6, IL-8, and interferon-gamma were determined by an enzyme immunoassay. Samples drawn on day 1 from 10 trauma patients without SIRS served as controls.


RESULTS
In 26 patients with SIRS without septic complication, sTREM-1, TNFalpha, and IL-8 remained stable over follow-up; IL-6 decreased and interferon-gamma increased on days 4 and 7 compared with day 1. TNFalpha was the only variable being higher upon advent of septic shock compared with patients without SIRS and upon presentation of SIRS, sepsis, and severe sepsis (p of comparisons with all subgroups <0.0001). Mortality of patients with sTREM-1 greater than 180 pg/mL was 5.3% compared with 28.0% of those with sTREM-1 lower than 180 pg/mL (p 0.035). sTREM-1 higher than 40 pg/mL had sensitivity 56.5% and specificity 91.7% for the differential diagnosis between SIRS and sepsis after multiple injuries.


CONCLUSIONS
This is the first study providing evidence about the participation of sTREM-1 in posttraumatic SIRS. Its levels are increased and remain constant over time in patients who did not develop any complications whereas it seems to behave as an anti-inflammatory mediator.
Giamarellos-Bourboulis
Evangelos J
EJ
4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece. giamarel@ath.forthnet.gr
Mouktaroudi
Maria
M
Tsaganos
Thomas
T
Koutoukas
Pantelis
P
Spyridaki
Ekaterini
E
Pelekanou
Aimilia
A
Kotzampassi
Katerina
K
D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000175:diagnosis / Q000276:immunology; D003428:Cross Infection / Q000175:diagnosis / Q000276:immunology; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D015601:Injury Severity Score; D007371:Interferon-gamma / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000276:immunology; D009104:Multiple Trauma / Q000276:immunology*; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011704:Pyelonephritis / Q000175:diagnosis / Q000276:immunology; D011971:Receptors, Immunologic / Q000097:blood*; D012772:Shock, Septic / Q000175:diagnosis / Q000276:immunology; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000276:immunology*; D013997:Time Factors; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
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; D007371:Interferon-gamma