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

• Published in: Clinical and experimental immunology 2005-10, Vol.142 (1), p.62-67
• Main Authors: Routsi, C., Giamarellos‐Bourboulis, E. J., Antonopoulou, A., Kollias, S., Siasiakou, S., Koronaios, A., Zakynthinos, S., Armaganidis, A., Giamarellou, H., Roussos, C.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Disease Progression; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunopathology; Interleukin-6 - blood; Interleukin-8 - blood; Male; Medical sciences; Membrane Glycoproteins - immunology; Middle Aged; Original; Pneumonia - immunology; Prospective Studies; Receptors, Immunologic - immunology; sepsis; Sepsis - blood; Sepsis - immunology; septic shock; Shock, Septic - blood; Shock, Septic - immunology; sTREM‐1; survival; Triggering Receptor Expressed on Myeloid Cells-1; Tumor Necrosis Factor-alpha - analysis
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1111/j.1365-2249.2005.02887.x

Summary In 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 (TNFα), interleukin‐6 (IL‐6), IL‐8 and sTREM‐1 were estimated in serum by an enzymeimmunoassay. No differences in concentrations of TNFα, 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 TNFα 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.