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Huh, Jung, Lim, Koh, and Hong: Prognostic Utility of the Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Patients with Acute Respiratory Distress Syndrome
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(4): 301-307.

Published online: 31 October 2008

DOI: https://doi.org/10.4046/trd.2008.65.4.301

Prognostic Utility of the Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Patients with Acute Respiratory Distress Syndrome

Jin Won Huh, M.D.1, Hoon Jung, M.D.1, Chae-Man Lim, M.D.2, Younsuck Koh, M.D.2, Sang-Bum Hong, M.D.2

1Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

2Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Sang-Bum Hong, M.D. Division of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3134, Fax: 82-2-3010-6968, sbhong@amc.seoul.kr

Received 29 August 2008       Accepted 1 October 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

The triggering receptor expressed on myeloid cells-1 (TREM-1) is an activating receptor that is expressed on the surface of neutrophils and mature monocytes when stimulated with several microbial components, which can amplify the inflammatory response. This study analyzed the prognostic value of the sTREM-1 levels in patients with acute respiratory distress syndrome (ARDS).

Methods

The bronchoalveolar lavage (BAL) fluid and blood was collected prospectively from 32 patients with ARDS, 15 survivors and 17 nonsurvivors. An enzyme-linked immunosorbent assay was performed to measure the sTREM-1. The following data was obtained: APACHE II score, Clinical Pulmonary Infection Score (CPIS), BAL fluid analysis, C-reative protein. Mortality in the ICU was defined as the end point.

Results

The serum sTREM-1 level was significantly higher in the nonsurvivors than survivors (54.3±10.3 pg/ml vs. 22.7±2.3 pg/ml, p<0.05). The sTREM-1 level in the serum, but not in the BAL fluid, was an independent predictor of the ICU mortality (OR: 22.051, 95% CI: 1.780~273.148, p<0.016), and a cut-off value of ≥33 pg/ml yielded a diagnostic sensitivity of 71% and specificity of 93%.

Conclusion

The serum sTREM-1 level may be a useful predictor of the outcome of ARDS patients.

Keywords: Acute respiratory distress syndrome, Triggering receptor expressed on myeloid cells-1, Prognosis, Mortality

Figures and Tables

Figure 1
Concentration of sTREM-1 in BAL fluid and serum of patients with ARDS. (A) All patients. (B) Pulmonary ARDS.
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Figure 2
Receiver operating characteristics curve for cut-off levels of soluble triggering receptor expressed on myeloid cells (sTREM-1) for prognostic factor. Areas under the ROC curve were 0.776 (95% CI, 0.606-0.947, p<0.05) for serum sTREM-1.
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Table 1
Baseline characteristics of patients with ARDS
trd-65-301-i001

Data are presented as means±SE.

APACHE: acute physiologic and chronic health evaluation; ARDS: acute respiratory distress syndrome; ARDSp: pulmonary ARDS; ARDSexp: extrapulmonary ARDS; ICU: intensive care unit.

Table 2
Laboratory data of patients with ARDS
trd-65-301-i002

Data are presented as means±SEM.

*p<0.05.

Table 3
sTREM-1 level according to the etiology
trd-65-301-i003
Table 4
Multiple logistic-regression analysis of prognostic factors
trd-65-301-i004

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