title: Early changes of the kinetics of monocyte trem-1 reflect final outcome in human sepsis.
abstract: BACKGROUND
  TREM-1 (triggering receptor expressed on myeloid cells), a receptor expressed on neutrophils and monocytes, is upregulated in sepsis and seems to tune the inflammatory response. We explored the expression of TREM-1 at the gene level and on cell membranes of monocytes and association with clinical outcome.
  
  
  METHODS
  Peripheral venous blood was sampled from 75 septic patients (39 patients with sepsis, 25 with severe sepsis and 11 with septic shock) on sepsis days 1, 3 and 7. TREM-1 on monocytes was measured by flow cytometry; gene expression of TREM-1 in circulating mononuclear cells was assessed by real-time PCR. sTREM-1 was measured in serum by an enzyme immunoassay.
  
  
  RESULTS
  Although surface TREM-1, sTREM-1 and TREM-1 gene expression did not differ between sepsis, severe sepsis and septic shock on day 1, survivors had greater expression of surface TREM-1 on days 3 and 7 compared to non-survivors. sTREM-1 on non-survivors decreased on day 3 compared to baseline. Patients with increase of monocyte gene expression of TREM-1 from day 1 to day 3 had prolonged survival compared to patients with decrease of gene expression of TREM-1 from day 1 to day 3 (p: 0.031).
  
  
  CONCLUSIONS
  Early decrease of gene expression of TREM-1 in monocytes is associated with poor outcome. A reciprocal decrease of the pro-inflammatory surface receptor TREM-1 linked with sepsis-induced immunosuppression may be part of the explanation.
authors.affiliation: 2nd Department of Internal Medicine, Sismanogleion General Hospital, 15126, Athens, Greece. nmarioli@yahoo.gr.
authors.forename: Androniki
authors.initials: A
authors.lastname: Marioli
authors.affiliation: 1st Department of Internal Medicine, Thriasio General Hospital, 19600, Elefsis, Greece. e-Lambros@hotmail.gr.
authors.forename: Marina
authors.initials: M
authors.lastname: Koupetori
authors.affiliation: 4th Department of Internal Medicine, Medical School, University of Athens, 12462, Athens, Greece. mrafotgiann@med.uoa.gr.
authors.forename: Maria
authors.initials: M
authors.lastname: Raftogiannis
authors.affiliation: Intensive Care Unit, Korgialeneion-Benakeion Hospital, 11526, Athens, Greece. mpatrani@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Patrani
authors.affiliation: 4th Department of Internal Medicine, Medical School, University of Athens, 12462, Athens, Greece. doc.kantonak@gmail.com.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Antonakos
authors.affiliation: Department of Internal Medicine, Argos General Hospital, 21200, Argos, Greece. mar_paul300@yahoo.gr.
authors.forename: Maria
authors.initials: M
authors.lastname: Pavlaki
authors.affiliation: 1st Department of Internal Medicine, G.Gennimatas General Hospital, 11527, Athens, Greece. geo.adamis@gmail.com.
authors.forename: Georgios
authors.initials: G
authors.lastname: Adamis
authors.affiliation: 4th Department of Internal Medicine, Medical School, University of Athens, 12462, Athens, Greece. diamanti.kons@gmail.com.
authors.forename: Georgia
authors.initials: G
authors.lastname: Dougekou
authors.affiliation: 4th Department of Internal Medicine, Medical School, University of Athens, 12462, Athens, Greece. gdamoraki@gmail.com.
authors.forename: Georgia
authors.initials: G
authors.lastname: Damoraki
authors.affiliation: 2nd Critical Care Department, "Attikon" University Hospital, 1 Rimini Str., Athens, 12462, Greece. itsagkaris@med.uoa.gr.
authors.forename: Iraklis
authors.initials: I
authors.lastname: Tsangaris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005786:Gene Expression Regulation / Q000276:immunology*; D006801:Humans; D007700:Kinetics; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood / Q000276:immunology; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D011971:Receptors, Immunologic / Q000097:blood / Q000276:immunology; D018805:Sepsis / Q000097:blood / Q000276:immunology / Q000401:mortality; D015996:Survival Rate; D000073871:Triggering Receptor Expressed on Myeloid Cells-1
chemical_list: D008562:Membrane Glycoproteins; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1