Universidade Federal do Rio Grande do Sul (UFRGS) and Intensivist Physician at the Intensive Care Unit of Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos 2350, CEP 90035-903 Porto Alegre, RS, Brazil.
School of Pharmacy of Centro Universitário Unilasalle, Rua Victor Barreto 2288, CEP 92010-903 Canoas, RS, Brazil.
Clin Biochem. 2021 Dec;98:10-16. doi: 10.1016/j.clinbiochem.2021.07.016. Epub 2021 Jul 30.
Triggering receptors expressed on myeloid cells 1 and 2 (TREM-1 and TREM-2) are cell surface receptors important for modulation of microglia immune response. In this study, we evaluate serum levels of TREM-1 and TREM-2 as potential biomarkers in acute ischemic stroke (AIS).
Prospective cohort study of 50 patients with AIS admitted at our hospital. Serum TREM-1 and TREM-2 was evaluated within 24 h of the acute event and on the third and fifth days after the stroke. Neurological stroke severity and global disability were determined with the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at the same three times and at the time of hospital discharge.
TREM-1 and TREM-2 levels were elevated in stroke. TREM-1, but not TREM-2, exhibited correlations with NIHSS and mRS within 24 h (NIHSS and TREM-1: r = 0.31, p = 0.029; mRS and TREM-1: r = 0.32, p = 0.023). The serum level of TREM-1 within 24 h correlated with the neurological outcomes at hospital discharge (NIHSS and TREM-1: p = 0.021; mRS and TREM-1: p = 0.049). The serum concentrations of TREM-1 protein within 24 h after stroke was significantly higher in patients with poor outcome (mRS > 2) at hospital discharge (p = 0.021). After Exact Logistic Regression, large segmental stroke (O.R. = 4.14; 95CI = 1.07-16.09; p = 0.040) and initial sTREM levels (O.R. = 1.02; 95CI 1.00-1.04; p = 0.045) remained independent prognostic factors for AIS poor outcome (mRS > 2).
In our study, TREM-1 and TREM-2 were significantly increased in AIS. Early elevation of TREM-1 correlated with stroke severity and it was an independent prognostic factor for stroke outcome.
髓系细胞触发受体 1 和 2（TREM-1 和 TREM-2）是细胞表面受体，对于调节小胶质细胞免疫反应非常重要。在本研究中，我们评估了血清 TREM-1 和 TREM-2 作为急性缺血性脑卒中（AIS）的潜在生物标志物。
前瞻性队列研究纳入了 50 例在我院就诊的 AIS 患者。在急性事件发生后 24 小时内和脑卒中后第 3 天及第 5 天评估血清 TREM-1 和 TREM-2。在同一三个时间点和出院时，使用国立卫生研究院卒中量表（NIHSS）和改良 Rankin 量表（mRS）评估卒中的严重程度和总体残疾程度。
脑卒中时 TREM-1 和 TREM-2 水平升高。TREM-1 但不是 TREM-2，在 24 小时内与 NIHSS 和 mRS 相关（NIHSS 和 TREM-1：r=0.31，p=0.029；mRS 和 TREM-1：r=0.32，p=0.023）。24 小时内的 TREM-1 血清水平与出院时的神经功能结局相关（NIHSS 和 TREM-1：p=0.021；mRS 和 TREM-1：p=0.049）。脑卒中后 24 小时内，预后不良（mRS＞2）患者的 TREM-1 蛋白血清浓度显著较高（p=0.021）。经Exact Logistic Regression 分析，大节段性卒中（OR=4.14；95CI=1.07-16.09；p=0.040）和初始 sTREM 水平（OR=1.02；95CI 1.00-1.04；p=0.045）是 AIS 预后不良（mRS＞2）的独立预后因素。
在本研究中，TREM-1 和 TREM-2 在 AIS 中明显升高。TREM-1 的早期升高与卒中严重程度相关，是卒中结局的独立预后因素。
