மருத்துவ நுண்ணுயிரியல் & நோய் கண்டறிதல்

The Role of TREM-1 Gene Expression and Soluble TREM-1 as Prognostic Markers of Sepsis

Abstract

Dina M Atef , Rania A Ghonaim and Eslam N Nada

Background: Determination of TREM-1 expression on monocytes has been investigated as a perspective diagnostic method to distinguish infectious from non-infectious etiology of the inflammation.
Objectives: To analyse the expression of the TREM-1 gene in patients of sepsis and septic shock and its relation with the severity of pathophysiological conditions. Also to describe the dynamics changes of soluble TREM- 1, procalcitonin and C-reactive protein during the course of sepsis and Correlation between their expressions and the clinical scoring system known as APACHE II scoring system.
Material and Methods: After an ethical approval, the expression of mRNA of TREM-1 in PMNs was detected in 76 critically ill patients (49 with sepsis and 27 with septic shock) were analyzed by using quantitative real-time PCR. The concentration of s. TREM-1, CRP and PCT levels were measured by an enzyme immunoassay.
Results: On the ICU admission, the septic shock group displayed higher levels of sTREM-1, PCT, APACHE II score (P<0.001) and CRP (P=0.01) than the sepsis group. Significant positive correlation (P<0.05) between APACHE II and both sTREM-1 and PCT in the prognosis of morbidity were shown. The mRNA levels of patients suffering from sepsis and septic shock were 0.54- and 0.39-fold lower compared to those of healthy subjects (1.06) respectively.
Conclusion: With regard to sepsis diagnosis and severity, sTREM-1 and PCT have positive values in prognostic assessment of the disease and may be taken as a survival-impacting risk factor. The TREM-1 gene expression levels isolated from patients with sepsis may be used as a surrogate marker for determining the severity.