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- Title
Expression of the triggering receptor expressed on myeloid cells-1 mRNA in a heterogeneous infected population.
- Authors
How, C.-K.; Chern, C.-H.; Wu, M.-F.; Wang, L.-M.; Huang, C.-I.; Lee, C.-H.; Hsieh, S.-L.
- Abstract
This study is to investigate the clinical utility of detection of peripheral blood triggering receptor expressed on myeloid cells (TREM)-1 mRNA as an early indicator of sepsis among critically ill patients and to compare the results of TREM-1 with those of C-reactive protein (CRP). A prospective, non-interventional study of 127 patients with at least two criteria of the systemic inflammatory response (SIRS) was performed. TREM-1 was assessed by real-time quantitative reverse transcription-polymerase chain reaction. The diagnosis of SIRS only was made in 41 patients (32%), and the diagnosis of sepsis was made in other 86 patients (68%). TREM-1 mRNA expression had the comparably discriminative value to differentiate the presence from the absence of infection, with an area under the receiver-operating characteristic curve ( AUC) of 0.75 [95% confidence interval (95% CI), 0.67–0.84] than CRP [ AUC, 0.72 (95% CI, 0.62–0.81)]. As an indicator of sepsis, a TREM-1 mRNA expression ratio cutoff value of 58.8 had a sensitivity of 72%, a specificity of 71%, a positive likelihood ratio of 2.5 and a negative likelihood ratio of 0.39. Furthermore, TREM-1 mRNA expression was selectively higher in septic patients caused by extracellular bacteria or fungi [112.4 (19.3–680.1)], than in those caused by intracellular bacteria or viruses [18.8 (7.6–53.0), p < 0.001]. There was no difference in plasma CRP levels between both septic groups (p = 0.782). TREM-1 and CRP are similar diagnostic markers of sepsis. The different ability of extracellular and intracellular pathogens to induce TREM-1 expression may provide a potential marker for differential diagnosis.
- Publication
International Journal of Clinical Practice, 2009, Vol 63, Issue 1, p126
- ISSN
1368-5031
- Publication type
Article
- DOI
10.1111/j.1742-1241.2006.01193.x