Does soluble triggering receptor expressed on myeloid cells-1 play any role in the pathogenesis of septic shock?

Abstract

SummaryIn order to define the significance of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) upon progression from sepsis or severe sepsis to septic shock a prospective study was designed with 90 enrolled patients with septic syndrome due to ventilator-associated pneumonia. Blood was sampled on seven consecutive days upon initiation of symptoms and concentrations of tumour necrosis factor-alpha (TNFa a a a ), interleukin-6 (IL-6), IL-8 and sTREM-1 were estimated in serum by an enzymeimmunoassay. No differences in concentrations of TNFa a a a , IL-6 and IL-8 were found between patients with sepsis, severe sepsis and septic shock on the first day of presentation of symptoms. Patients presenting with septic shock had concentrations of sTREM-1 significantly higher than both patients with sepsis and severe sepsis on the first day; no difference was found between patients with sepsis and severe sepsis. A positive correlation was detected between sTREM-1 and the white blood cell count. Serum levels of sTREM-1 were significantly lower in patients where VAP resolved compared to those where VAP did not resolve; similar findings were noted between patients who eventually survived and those who died. IL-6 followed the kinetics of sTREM-1 in correlation to patients's prognosis; levels of TNFa a a a and IL-8 were unrelated to prognosis. It is concluded that sTREM-1 is particularly increased upon evolution from sepsis or severe sepsis to septic shock. Its sustained increase is an indication of poor outcome. The underlined pathophysiological role of sTREM-1 for the transition from sepsis or severe sepsis to septic shock might constitute a novel target for immunomodulatory therapy.

Angiopoietin-2 Enhances Survival in Experimental Sepsis Induced by Multidrug-ResistantPseudomonas aeruginosa

“…This finding is compatible with overall lower leukocyte activation in the presence of Ang-2 or altered leukocyte distribution between peritoneum, blood, and tissues (Routsi et al, 2005).…”

Development and Validation of a Multiplex Add-On Assay for Sepsis Biomarkers Using xMAP Technology

“…This raises the question of the true concentration of sTREM-1 in plasma. To our knowledge, 4 studies have quantified sTREM-1 in plasma/serum (7,22,31,32 ). There is a 400-fold difference in the LOD among the assays used in the 4 studies, but this difference did not influence their abilities to quantify sTREM-1 in serum samples.…”

Expression pattern of soluble triggering receptor expressed on myeloid cells-1 in mice with Acinetobacter baumannii colonization and infection in the lung

“…It has been reported that activation of TREM-1 immediately induces rapid degranulation of neutrophilic granules and drives the release of proinflammatory factors, including MIP-1, MCP-1 and IL-8, thus playing an important regulatory role in inflammation (22). sTREM-1, the soluble form of TREM-1, has been demonstrated to be produced and secreted into body fluids including blood during microbial infections, and its expression level is closely associated with the severity of infection, including HAP caused by A. baumannii (11,23). It is worth noting that the specificity of sTREM-1 in bacterial infection still remains controversial.…”