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Abstract: Slide Presentations |

SOLUBLE TREM-1 (TRIGGERING RECEPTOR EXPRESSED ON MYELOID CELLS) IN PLEURAL EFFUSIONS: A MARKER OF INFECTIOUS DISEASE FREE TO VIEW

Faisal M. Bhutta, MD*; Barnette Randal, PhD; Magdalena Ornatowska, PhD; Richard Light, MD; Ruxana T. Sadikot, MD, MRCP
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University of Illinois at Chicago, Chicago, IL


Chest


Chest. 2007;132(4_MeetingAbstracts):462b. doi:10.1378/chest.132.4_MeetingAbstracts.462b
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Abstract

PURPOSE: TREM-1 is a recently described glycoprotein receptor of the immunoglobulin superfamily, which is expressed on cell membranes of granulocytes, monocytes, and a subset of macrophages. Engagement of TREM-1 has been reported to trigger synthesis of pro-inflammatory cytokines in response to microbes and play an important role in the innate immune response. A soluble form of TREM-1 (sTREM-1) is shed from the membranes of activated phagocytes. sTREM-1 has been shown to be a marker of infectious inflammation in models of sepsis and ventilator associated pneumonias. In the present study we investigated whether levels of sTREM-1 in pleural fluid would aid in the diagnosis of parapneumonic effusions.

METHODS: Pleural fluid from forty patients who had undergone a thoracentesis were included in the study. The etiology of the pleural effusions was as follows: Parapneumonic(n=10); Malignant(n=10); CHF(n=10); PostCABG(n=10). Pleural fluid was analyzed for RBC count, WBC count and differential, LDH, Protein and Glucose and categorized as exudate or transudate using Light's criteria. sTREM-1 assay was performed on these samples using quantitative sandwich ELISA.

RESULTS: 1)sTREM-1 levels were significantly higher in Parapneumonic effusions compared to other etiologies (p<0.001). For a cutoff value of 675 pg/ml, sTREM-1 had a sensitivity of 90% (95% confidence interval 55 to 99%); specificity of 87% (95% confidence interval 69 to 96%); positive likelihood ratio of 6.75; and negative likelihood ratio of 0.115.2) There was a significant correlation between total and absolute neutrophil counts and sTREM-1.3)There was no significant correlation between the lymphocyte count,LDH or protein and sTREM-1.

CONCLUSION: Levels of sTREM-1 are increased in parapneumonic effusions and may prove to be of diagnostic value. Whether the levels may help in distinguishing complicated from simple parapneumonic effusions needs further studies.

CLINICAL IMPLICATIONS: sTREM-1 may prove to be a diagnostic marker and aid in distinguishing parapneumonic effusions from other exudative pleural effusions.

DISCLOSURE: Faisal Bhutta, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, October 23, 2007

10:30 AM - 12:00 PM


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