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

¹ Division of Respiratory and Critical Care Medicine, Dept of Medicine, Depts of ² Laboratory Medicine, and, ⁴ Pathology, National University Hospital, Singapore, Depts of ³ Pathology, and, ⁵ Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, ⁶ Authors contributed equally to the study.

CORRESPONDENCE: T. K. Lim, Division of Respiratory and Critical Care Medicine, Dept of Medicine, National University Hospital, 5 Lower Kent Ridge Road, 119074 Singapore. Fax: 81 6567724361. E-mail: mdclimtk{at}nus.edu.sg

Keywords: Antibiotics, asthma, chronic obstructive pulmonary disease, pneumonia, respiratory infections, soluble form of the triggering receptor expressed on myeloid cells-1

Received: January 14, 2006
Accepted June 23, 2006

Levels of the soluble form of the triggering receptor expressed on myeloid cells (sTREM)-1 are elevated in severe sepsis. However, it is not known whether sTREM-1 measurements can distinguish milder bacterial infections from noninfectious inflammation. The present authors studied whether serum sTREM-1 levels differ in community-acquired pneumonia, exacerbations of chronic obstructive pulmonary disease (COPD), asthma and controls, and whether 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 with controls (83.1 ng·mL^-1). Levels were higher in pneumonia and Anthonisen type 1 COPD exacerbations than in type 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 levels of the soluble form of the triggering receptor expressed on myeloid cells-1 were elevated predominantly in pneumonia and Anthonisen type 1 COPD exacerbations versus type 2 and 3 chronic obstructive pulmonary disease exacerbations, asthma and controls. Serum levels of the soluble form of the triggering receptor expressed on myeloid cells-1 has moderate but insufficient accuracy as a surrogate marker for the need for antibiotics in lower respiratory tract infections.

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