ObjectiveTo summarize the advance of triggering receptor expressed on myeloid cells-1 (TREM-1). MethodsLiteratures about the recent studies on the TREM-1 were reviewed. ResultsTREM1 was a mediator of inflammation. It could amplify the inflammation and lead to overexpression of inflammation in final. ConclusionTREM-1 is very important in development of many diseases and provide a new molecule target to cure.
ObjectivesTo systematically review the prognostic value of plasma soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) level in predicting 28-day mortality in sepsis.MethodsPubMed, The Cochrane Library, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies about the prognostic value of plasma sTREM-1 in early 28-day mortality in sepsis from inception to April 16th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 14.0 software.ResultsA total of 13 studies involving 1 115 patients were included. The results of meta-analysis showed that the sensitivity and specificity were 79% and 77%, respectively. The positive likelihood ratio and the negative likelihood ratio were 3.4 and 0.28, respectively. The diagnostic ratio was 12. The overall area under the summary receiver operator characteristic (SROC) curve was 0.80.ConclusionsCurrent evidence shows that plasma sTREM-1, as a single index, may play a prognostic role in the early 28-day mortality of sepsis in patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To study the diagnostic and prognostic value of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and cyclooxygenase-2 (COX-2) in abdominal infection-caused sepsis. Methods A total of 170 patients with abdominal infection treated in the First Hospital of Qinhuangdao between January 2019 and March 2022 were retrospectively selected and divided into sepsis group (n=76) and non-sepsis group (n=94) according to whether they were combined with abdominal infection-caused sepsis. In addition, 80 healthy people in the same period were selected as the control group. The levels of serum sTREM-1 and COX-2 in the three groups were detected and the differences were compared. The laboratory indexes, including white blood cell count, high-sensitivity C-reactive protein, and procalcitonin of patients with abdominal infection-caused sepsis were detected. The Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System Ⅱ and prognosis (survival or death) of patients with abdominal infection-caused sepsis were evaluated. The correlations of serum sTREM-1 and COX-2 with the severity of sepsis were analyzed, and the diagnostic and prognostic value of sTREM-1 and COX-2 in abdominal infection-caused sepsis was assessed. Results The levels of serum sTREM-1 and COX-2 in the sepsis group were higher than those in the control group and the non-sepsis group (P<0.05). The levels of serum sTREM-1 and COX-2 in the sepsis group were positively correlated with white blood cell count, high-sensitivity C-reactive protein, procalcitonin, Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System Ⅱ score (P<0.05). The serum levels of sTREM-1 and COX-2 of patients who died during hospitalization in the sepsis group were higher than those of the surviving patients. The areas under the receiver operating characteristic curves of the serum sTREM-1 and COX-2 levels for diagnosing sepsis caused by abdominal infection were 0.814 [95% confidence interval (CI) (0.746, 0.882), P<0.001] and 0.848 [95%CI (0.788, 0.905), P<0.001], respectively, with critical values of 1.879 pg/mL and 18.75 ng/mL, respectively, and those for predicting the prognosis of patients with sepsis caused by abdominal infection were 0.775 [95%CI (0.659, 0.890), P<0.001] and 0.784 [95%CI (0.679, 0.889), P<0.001], respectively, with critical values of 2.283 pg/mL and 23.02 ng/mL, respectively (P<0.05). Conclusion The serum levels of sTREM-1 and COX-2 have certain value in the diagnosis and prognosis prediction of abdominal infection-caused sepsis.
Objective To observe the changes of soluble triggering receptor expressed on myeloid cell-1 ( sTREM-1) and inflammatory mediators levels in plasma of severe pneumonia patients, and explore the significance of systemic inflammatory response state.Methods Plasma levels of sTREM-1, tumor necrosis factor-α ( TNF-α) and interleukin-10 ( IL-10) were examined in 40 patients with severe pneumonia, 25 patients with uncomplicated pneumonia, and 15 healthy volunteers. Plasma levels of TNF-α,IL-10 and sTREM-1 in survival and non-survival severe pneumoniawere observed on days 1,4, 7 and the day of discharge or death.Results Plasma levels of TNF-α, IL-10, and sTREM-1 [ ( 44. 25 ±10. 81) pg/mL,( 58. 21 ±16. 41) pg/mL, ( 51. 75 ±18. 51) pg/mL, respectively] in the patients with severe pneumonia were higher than those with uncomplicated pneumonia [ ( 24.6 ±6. 45) pg/mL, ( 24. 56 ±7. 1) pg/mL,( 25. 55 ±7. 72) pg/mL, respectively] and the normal controls [ ( 13. 82 ±4. 04) pg/mL, ( 15. 30 ±4. 45)pg/mL, ( 14. 37 ±4. 82) pg/mL, respectively] ( P lt;0. 001) . Plasma levels of TNF-α, IL-10, and sTREM-1 were gradually decreased in the survivors, while maintained at high levels or increased in the non-survivors.The levels of these mediators were all significantly higher in the non-survivors than the survivors at all time points. The ratio of TNF-α/ IL-10 level was higher in the severe pneumonia patients than the uncomplicated pneumonia patients and the control subjects ( 1. 286 ±0. 177 vs. 1. 077 ±0. 410 and 0. 932 ±0. 154) on day 1.The ratio of TNF-α/IL-10 level was higher in the non-survivors than the survivors at all time points. There was negative correlation between plasma levels of sTREM-1 and TNF-αon day 1 ( r = - 0. 479, P =0. 002) ,and positive correlation between plasma levels of sTREM-1 and IL-10 on day 1 ( r = 0. 326, P = 0. 040) .Conclusions There are excessive release of inflammatory mediators and unbalanced systemic inflammatory response in patients with severe pneumonia, especially in non-survivors. sTREM-1, TNF-α and IL-10 are involved in the inflammatory response, and their levels may reflect the prognosis.
ObjectiveTo investigate the clinical value of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) for diagnosis and prognosis of sepsis. MethodsPatients with SIRS (n=58) were divided into a sepsis group (n=40) and a non-sepsis group (n=18),and 12 healthy adults were admitted as control. Serum concentrations of sTREM-1,interleukin-6 (IL-6) and IL-10 were measured on days 1,3,7 and 14 by ELISA. According to the survival on 28th day after admission,the sepsis group was divided into survivors (n=27) and non-survivors (n=13). APACHEⅡ score and SOFA score were used to evaluate the severity of sepsis. The correlations between sTREM-1 and IL-6,IL-10,disease progression or prognosis were analyzed respectively. ResultsOn the first day of enrollment,sTREM-1,IL-6 and IL-10 [217.28(136.02-377.01) pg/mL,218.76(123.32-548.58) pg/mL and 93.86(54.23-143.1) pg/mL,respectively] in the sepsis group were significantly higher than those in the non-sepsis group [55.51(39.50-77.33) pg/mL,75.98(34.89-141.03) pg/mL and 52.49(45.66-56.72) pg/mL,respectively] and the control group [43.99(36.28-53.81) pg/mL,46.07(40.23-53.72) pg/mL and 49.79(43.31-53.14) pg/mL, respectively] (All P<0.01). For diagnosis of sepsis,the area under the curve (AUC) for sTREM-1 was 0.82 (95%CI 0.70-0.94). Levels of sTREM-1 and IL-10 in survivors of sepsis were gradually increased on 1st,3rd,7th day of enrollment,while level of sTREM-1 in non-survivors showed an obvious decrease during the observation. On the 14th of admission,sTREM-1,IL-6,IL-10 and IL-6/IL-10 ratio of non-survivors were significantly higher than those of survivors (P<0.05). There were significantly positive correlations between sTREM-1 and APACHEⅡ score,SOFA score,IL-6,IL-10 or IL-6/IL-10 ratio (r=0.624,0.454,0.407 and 0.324,respectively,all P<0.05). Logistic regression analysis indicated that serum level of sTREM-1 may be used as a prognostic factor of sepsis,but not an independent risk factor. ConclusionSerum sTREM-1 could be used as a marker to detect sepsis early,and sTREM-1 is also involved in systemic inflammatory reaction of sepsis patient and appears to be a prognostic value of sepsis.
Objective To observe the expression of triggering receptor expressed on myeloid cells (TREM), Caspase-3 and interleukin (IL)-6 in optic nerve tissue of ischemic optic neuropathy (ION). Methods Twenty Sprague-Dawley rats were randomly divided into control group and model group, 10 rats in each group. The permanent ligation of bilateral internal carotid arteries (BICA) was performed for 14 days to establish sub-acute ION model as model group. The control group were separated BICA without ligation. The expressions of TREM-1, TREM-2, Caspase-3 and IL-6 in rat retina were detected by reverse transcription PCR and Western blot, respectively. ResultsCompared with the control group, the expressions of TREM-1, Caspase-3, IL-6 mRNA (t=6.058, 7.86, 6.055) and protein (t=9.671, 9.524, 14.501) in the optic nerve tissue of the model group were increased, while the expression of TREM-2 mRNA and protein (t=9.283) was decreased, and the difference was statistically significant (P＜0.05). Conclusion In ischemic optic nerve tissue, TREM-1 mRNA and protein were significantly expressed, the expressions of TREM-2 mRNA and protein decreased significantly.
Objective To investigate the transduction pathway of TREM-1 during endotoxininduced acute lung injury ( ALI) in mice through the specific activating or blocking TREM-1.Methods 40 mice were randomly divided into a saline control group, an ALI group, an antibody group, and a LP17 group ( 3.5 mg/kg) . All mice except the control group were intraperitoneally injected with lipopolysaccharide ( LPS) to establish mouse model of ALI. Two hours after LPS injection, anti-TREM-1mAb ( 250 μg/kg) was intraperitoneally injected in the antibody group to activation TREM-1, and synthetic peptide LP17 was injected via tail vein in the LP17 group to blocking TREM-1. After 6,12,24, 48 hours, 3 mice in each group were sacrificed for sampling. The expression of NF-κB in lung tissue was determined by immunohistochemistry. The levels of TNF-α, IL-10, TREM-1, and soluble TREM-1 ( sTREM-1) in lung tissue and serumwere measured by ELISA. Pathology changes of lung were observed under light microscope, and Smith’s score of pathology was compared. Results Administration of anti-TREM-1mAb after ALI modeling significantly increased the NF-κB expression in lung tissue at 48h, resulting in a large number of pro-inflammatory cytokines releasing in the lung tissue and serumand lung pathology Smith score increasing. Administration of LP17 after modeling significantly down-regulated the expressions of NF-κB and pro-inflammatory cytokines, while led to a slight increase of anti-inflammatory cytokines and a decline of lung pathology Smith’s score.Conclusion TREM-1 may involve in inflammatory response by promoting the generation of inflammatory factors via NF-κB pathway, thus lead to lung pathological changes in ALI.
Objective To evaluate the effect of auto adjusted triggering mechanism on the triggering balance of sensitivity and anti-interference in non invasive ventilator field. Methods Taking the breathing simulator as the experimental platform, for the same ventilator, the experiments of "automatic adjustment mode" and "manual adjustment mode" were carried out in a self-control manner, comparing the sensitivity and anti-interference indexes of the experimental group and the control group in the triggering stage. The results were statistically analyzed. Results In case of large air leakage, for ventilator of "A40", the group of "automatic adjustment mode" presented auto-triggered cycle and the group of "manual adjustment mode" (the inspiratory trigger sensitivity was adjusted to 5 to 9 L/min) could provide breathing assistance ventilation. While for ventilator of "VENT", both the group of "automatic adjustment mode" and the group of "manual adjustment mode" (the inspiratory trigger sensitivity was adjusted to 1 to 8 arbitrary unit) appear auto-triggered cycle. In case of medium air leakage, for ventilator of "A40", the trigger delay time, trigger pressure and trigger work of the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 3 to 5 L/min) were significantly less than those of the "automatic adjustment mode" group, and the trigger delay time, trigger work of the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 8 to 9 L/min) were significantly higher than those of the "automatic adjustment mode" group; While for ventilator of "VENT", compared with the inspiratory trigger sensitivity of the "automatic adjustment mode" group and the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 4 arbitrary unit), the trigger delay time, trigger pressure and trigger work were not statistically significant. In case of small air leakage, for ventilator of "A40", the trigger delay time and trigger work of the "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 2 to 6 L/min) were significantly less than those in the "automatic adjustment mode" group, and the trigger pressure of "manual adjustment mode" group (the inspiratory trigger sensitivity was adjusted to 2 to 5 L/min and 7 L/min) was significantly lower than that of "automatic adjustment mode" group. While for ventilator of "VENT", the trigger delay time, trigger pressure and trigger work of the "manual adjustment" group (the inspiratory trigger sensitivity was adjusted to 1 to 2 arbitrary unit) were less than those of the experimental group, and they were statistically significant. Conclusions In case of large air leakage, ventilator of "VENT" can not provide breathing assistance ventilation no matter which inspiratory trigger mode. While ventilator of "A40" should be used the "manual adjustment mode", and adjust the inspiratory trigger sensitivity to the less sensitive arbitrary unit to increase its performance of anti-interference. In case of medium air leakage, for both ventilator of "A40" and ventilator of "VENT", it is better to use "automatic adjustment" mode for breathing assistance ventilation. In case of small air leakage, for both ventilator of "A40" and ventilator of "VENT", it is better to use "manual adjustment" mode for breathing assistance ventilation and we should adjust the inspiratory trigger sensitivity to the higher sensitive arbitrary without auto-triggered cycle.
Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 ( sTREM-1 ) in endotracheal aspirate and plasma of patients with ventilator-associated pneumonia ( VAP) . Methods The consentration of sTREM-1 in plasma and endotracheal aspirate, and serum high-sensitivity C-reactive protein ( hs-CRP) were measured by enzyme-linked immunosorbent assay ( ELISA) in 68 patients with VAP ( VAP group) , 50 patients underwent ventilation without VAP ( non-VAP group) , and 50 healthy individuals ( control group) . The sensitivity and specificity of each parameter were calculated. Results In the patients with VAP, sTREM-1 in plasma and endotracheal aspirate before treatment were significantly higher than that in the non-VAP group [ ( 143.62 ±46.82) pg/mL vs. ( 68.56 ±16.24) pg/mL, ( 352.86 ±92.57) pg/mL vs. ( 126.21 ±42.28) pg/mL, Plt;0.05] ; sTREM-1 in plasma and endotracheal aspirate on the 3rd and the 7th day during treatment were significantly decreased ( Plt;0. 05) . By ROC analysis, the cut-off value of sTREM-1 in endotracheal aspirate were 193.64 pg/mL, with sensitivity and specificity of 93.84% and 89.51% respectively. The areas under ROC curve of sTREM-1 in endotracheal aspirate were 0.912. Clinical diagnostic value of sTREM-1 in endotracheal aspirate was better than plasma sTREM-1 and serum hs-CRP ( areas under ROC curve were 0. 768 and 0. 704 respectively) . Conclusions sTREM-1 may be helpful for evaluating the therapeutic effect in patients with VAP. The diagnostic value of sTREM-1 in endotracheal aspirate may be superior to plasma sTREM-1 and serum hs-CRP.