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.
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.
ObjectiveTo evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) level in bronchoalveolar lavage fluid (BALF) for discrimination of Acinetobacter baumannii (A. baumannii) colonization from infection.MethodsSixty patients with tracheal intubation or tracheotomy who were admitted in intensive care unit from July 2016 to July 2018, were divided into an infection group (n=20), a colonization group (n=20) and a control group (n=20). The serum and BALF samples were collected from the patients on the day when lower respiratory tract sample culture was positive so as to detect sTREM-1, serum procalcitonin (PCT) and interleukin-6 (IL-6). The value of serum PCT, IL-6, sTREM-1 and BALF sTREM-1 in differentiation of infection or colonization for A. baumannii was analyzed by mean of receiver operating characteristic (ROC) curve.ResultsThere were no significant differences in gender composition, age or Glasgow coma score among the three groups (P>0.05). The clinical pulmonary infection score (CPIS) of the infection group was higher than that in the control group (P<0.05). Compared with the control group, while the sTREM-1 concentration of BALF with A. baumannii colonization increased significantly but levels of PCT, IL-6 and sTREM-1 remained unchanged in serum. The levels of PCT, IL-6 and sTREM-1 in serum, and sTREM-1 in BALF increased significantly in the infection group (P<0.001). Compared with the colonization group, the levels of PCT, IL-6 and sTREM-1 in serum, and sTREM-1 in BALF increased significantly in the infection group (P<0.05). The area under the ROC curve (AUC) of serum PCT was 0.67 with the sensitivity of 0.55 and the specificity of 0.90 (95%CI 0.52 - 0.82). AUC of serum IL-6 was 0.72 with the sensitivity of 0.60 and the specificity of 0.95 (95%CI 0.58 - 0.85). AUC of serum sTREM-1 was 0.72 with the sensitivity of 0.75 and the specificity of 0.60 (95%CI 0.55 - 0.85). AUC of sTREM-1 in BALF was 0.92 with the sensitivity of 0.95 and the specificity of 0.70 (95%CI 0.79 - 0.98). The diagnostic accuracy of sTREM-1 in BALF was higher than that of PCT, IL-6 and sTREM-1 in serum (P<0.05).ConclusionssTREM-1 in BALF has good diagnostic performance in differentiating patients with infection of colonization for A. baumannii. Its sensitivity and specificity are higher than serum PCT, IL-6 and sTREM-1.
ObjectiveTo compare and evaluate the diagnostic value of procalcitonin(PCT) and soluble triggering receptor expressed on myeloid cells-1(sTREM-1) for ventilator-associated pneumonia(VAP). MethodsThe related studies were systematically searched in PubMed, OvidSP (EMBASE), Cochrane Library, clinicaltrials.gov, EBSCO, CBM, CNKI and Wanfang database and the methodological quality of all eligible studies were assessed using the Quality Assessment for Studies of Diagnostic Accuracy (QUADAS) tool. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and areas under the summary receiver operating characteristic (sROC) curve of PCT and sTREM-1 were pooled by Meta-disc software, respectively. Area under the sROC curve (AUC) was compared using Z-test. In addition, Bayes's theorem was used to calculate the probability of VAP, conditioned by the likelihood ratio as a function of the pretest probability. ResultsIn total, 31 studies were included (20 studies on PCT and 11 studies on sTREM-1). The combined sensitivity, specificity, DOR and AUC of diagnosing VAP by PCT was 0.78, 0.74, 15.21, and 0.868, respectively. And the combined sensitivity, specificity, DOR and AUC of diagnosing VAP by sTREM-1 was 0.88, 0.80, 30.28, and 0.919, respectively. There was no statistical difference between two areas under the sROC curve (P=0.25). ConclusionsTREM-1 is superior to PCT in diagnosing VAP, however, neither can confirm nor exclude VAP alone.
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.
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 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.
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.