Soluble triggering receptor expressed on myeloid cells-1 in acute respiratory infections

¹ Division of Respiratory and Critical Care Medicine, Dept of Medicine, National University Hospital, Singapore
² Dept of Laboratory Medicine, National University Hospital, Singapore; and Dept of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
³ Dept of Laboratory Medicine, National University Hospital, Singapore
⁴ Dept of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
⁵ Dept of Pathology, National University Hospital, Singapore
⁶ Division of Respiratory and Critical Care Medicine, Dept of Medicine, National University Hospital, Singapore; and Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

^* To whom correspondence should be addressed. E-mail: mdclimtk{at}nus.edu.sg.

	Abstract

Levels of the soluble form of the triggering receptor expressed on myeloid cells-1 (sTREM-1) are elevated in severe sepsis. However, it is unknown if sTREM-1 measurements can distinguish milder bacterial infections from non-infectious inflammation. We studied whether serum sTREM-1 levels differ in community acquired pneumonia, exacerbations of chronic obstructive pulmonary disease (COPD), asthma and controls, and if sTREM-1 may be used as a surrogate marker for the need for antibiotics.

Serum sTREM-1 levels in 150 patients with pneumonia, COPD and asthma exacerbations and 62 healthy controls were measured.

Serum sTREM-1 levels were significantly elevated in pneumonia (median 295.2 ng·ml^-1), COPD (280.3 ng·ml^-1) and asthma exacerbations (184.0 ng·ml^-1) compared to controls (83.1 ng·ml^-1). Levels were higher in pneumonia and Anthonisen type 1 COPD exacerbations than in types 2 and 3 COPD and asthma exacerbations. The area under the receiver operating characteristics curve for sTREM-1 as a surrogate marker for the need for antibiotics was 0.77.

Serum sTREM-1 levels are elevated predominantly in pneumonia and Anthonisen type 1 COPD exacerbations, versus types 2 and 3 COPD exacerbations, asthma and controls. Serum sTREM-1 has moderate but insufficient accuracy as a surrogate marker for the need for antibiotics in lower respiratory tract infections.

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