Source: Annual Congress 2008 - Mechanisms of respiratory infections: interaction between the pathogen and the host
Disease area: Respiratory infections

Abstract

Introduction: TREM-1 is a recently described receptor on neutrophils and monocytes. Its expression is increased in bacterial and fungal infections. Although increased levels of sTREM-1 have been detected in serum of patients with ventilator associated pneumonia, there is limited data on the value of TREM-1 in patients with less severe respiratory infection.
Aim: To investigate TREM-1 as a diagnostic marker of bacterial lung infection.
Methods: 102 patients admitted in a medical ward with acute respiratory illness were enrolled in this study. Neutrophil and monocyte TREM-1 expression were measured by flow cytometry and serum sTREM-1 by enzyme immunoassay.
Results: 43 patients were diagnosed with bacterial respiratory tract infection (group A) and 59 with non-bacterial pulmonary disease (group B). The median sTREM-1 concentration in group A was 98.24pg/ml and in group B 3.90(p<0.0001). A cut-off of 25pg/ml for sTREM-1 had sensitivity of 72% and specificity of 70%. Median neutrophil TREM-1 expression (MFI) was 3.7 in group A and 2.4 in group B (p=0.001). Median TREM-1 monocyte expression (MFI) was 4.1 in group A and 2.7 in group B (p=0.008). sTREM-1 concentrations were higher among patients with severe pneumonia (median 129.22pg/ml) and severe sepsis (median 479.84pg/ml) compared to patients with mild infections. sTREM-1 levels in group A decreased after the initiation of appropriate antibiotic therapy and resolution of pneumonia.
Conclusion: TREM-1 constitutes a reliable marker of bacterial infection in patients with respiratory tract infections and can be helpful in decisions regarding antimicrobial treatment.

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I. Porfyridis, D. Plachouras, V. Karagianni, A. Kotanidou, S. A. Papiris, H. Giamarellou, E. J. Giamarellos-Bourboulis (Athens, Greece). Triggering receptor expressed on myeloid cells (TREM)-1 and its soluble form (sTREM-1) as a diagnostic marker of bacterial lung infection. Eur Respir J 2008; 32: Suppl. 52, 2297

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