Giamarellos-Bourboulis Evangelos J, Zakynthinos Spyridon, Baziaka Fotini, Papadomichelakis Evangelos, Virtzili Simona, Koutoukas Pantelis, Armaganidis Apostolos, Giamarellou Helen, Roussos Charis
Fourth Department of Internal Medicine, University of Athens Medical School, University General Hospital Attikon, 1 Rimini Str., 12464, Athens, Greece.
First Department of Critical Care, Evangelismos Hospital, 17 Ipsilantou Str., 11526, Athens, Greece.
Intensive Care Med. 2006 Feb;32(2):237-243. doi: 10.1007/s00134-005-0017-1. Epub 2006 Feb 1.
To define the significance of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the septic cascade by comparing its kinetics to those of other proinflammatory mediators and of interleukin (IL) 10.
Prospective study in a tertiary unit.
Blood was sampled from 90 patients with septic syndrome due to ventilator-associated pneumonia for 7 days after the appearance of symptoms. Concentrations of tumor necrosis factor (TNF) alpha, IL-6, IL-8, IL-10, and sTREM-1 were determined by enzyme-linked immunosorbent assay.
Serum levels of TNFalpha, IL-6, IL-10, and sTREM-1 were higher in nonsurvivors than in survivors; similar differences were not found for IL-8. Positive correlations were found between the ratios IL-10/TNFalpha and sTREM-1/TNFalpha, between IL-10/IL-6 and sTREM-1/IL-6, and between IL-10/IL-8 and sTREM-1/IL-8. Median values of IL-10/TNFalpha upon presentation of sepsis, severe sepsis, and septic shock were 3.21, 2.16, and 2.86, respectively (NS). Respective values for sTREM-1/TNFalpha were 21.28, 7.33, and 27.78 (p=0.047 between sepsis and severe sepsis, p=0.003 between severe sepsis and septic shock).
sTREM-1 follows the kinetics of IL-10 and should therefore be considered an anti-inflammatory mediator in sepsis. Decreased ratios of sTREM-1/TNFalpha might determine transition from sepsis to severe sepsis and from severe sepsis to septic shock.
通过比较髓系细胞触发受体-1（sTREM-1）与其他促炎介质及白细胞介素（IL）-10的动力学变化，明确其在脓毒症级联反应中的意义。
在一家三级医疗机构进行的前瞻性研究。
对90例因呼吸机相关性肺炎导致脓毒症综合征的患者，在症状出现后7天内采集血液样本。采用酶联免疫吸附测定法测定肿瘤坏死因子（TNF）α、IL-6、IL-8、IL-10和sTREM-1的浓度。
非存活者的血清TNFα、IL-6、IL-10和sTREM-1水平高于存活者；IL-8未发现类似差异。IL-10/TNFα与sTREM-1/TNFα、IL-10/IL-6与sTREM-1/IL-6、IL-10/IL-8与sTREM-1/IL-8之间呈正相关。脓毒症、严重脓毒症和脓毒性休克出现时IL-10/TNFα的中位数分别为3.21、2.16和2.86（无显著差异）。sTREM-1/TNFα的相应值分别为21.28、7.33和27.78（脓毒症与严重脓毒症之间p = 0.047，严重脓毒症与脓毒性休克之间p = 0.003）。
sTREM-1遵循IL-10的动力学变化，因此在脓毒症中应被视为一种抗炎介质。sTREM-1/TNFα比值降低可能决定从脓毒症向严重脓毒症以及从严重脓毒症向脓毒性休克的转变。
