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Abstract: Slide Presentations |

TRIGGERING RECEPTORS EXPRESSED ON MYELOID CELLS IN PULMONARY ASPIRATION SYNDROMES FREE TO VIEW

Ahmad Alhajhusain, MD*; Morohunfolu E. Akinnusi, MD; Misha Peter, MD; Ilya Berim, MD; Marcus J. Schultz, MD; Lilibeth Pineda, MD; Ali A. El Solh, MD
Author and Funding Information

University at Buffalo, Buffalo, NY


Chest


Chest. 2008;134(4_MeetingAbstracts):s10003. doi:10.1378/chest.134.4_MeetingAbstracts.s10003
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Abstract

PURPOSE:To investigate the potential role of serum and alveolar soluble triggering receptor expressed on myeloid cells (sTREM-1) as a biological marker of pulmonary aspiration syndromes.

METHODS:Blood and bronchoalveolar lavage (BAL) fluid samples were collected on enrollment of seventy-five patients with pulmonary aspiration and 13 controls receiving mechanical ventilation in a prospective cohort study.Soluble TREM-1 levels were measured by an enzyme-linked immunosorbent assay.

RESULTS:Thirty-eight of 75 participants had documented BAL culture-positive pulmonary aspiration. While circulating levels of sTREM-1 were comparable between those with aspiration syndromes(19.81± 12.09 pg/ml) and controls (15.96± 11.16 pg/ml)(p = 0.27), the alveolar levels of sTREM-1 were higher in patients with culture-positive pulmonary aspiration (344.41± 152.82 pg/ml) compared with those culture-negative pulmonaryaspiration (142.76± 89.88 pg/ml; p < 0.001). A cut-off value of250 pg/ml for alveolar sTREM-1 achieved a sensitivity of 65.8%(95% CI 48.6–80.4) and a specificity of 91.9% (95% CI 78.1–98.2) with an area under the curve of 0.87 (95% CI 0.78–0.94).

CONCLUSION:Alveolar sTREM-1 levels can be a potential biomarker for distinguishing BAL culture-positive from BAL culture negativepulmonary aspiration.

CLINICAL IMPLICATIONS:In the absence of an accurate and valid marker to distinguish“aspiration pneumonia” with resultant bacterial pneumonia from non-bacterial “aspiration pneumonitis,” the majority of patients with the diagnosis of pulmonary aspiration receive antimicrobial therapy when treatment is indicated only for those with infectious pneumonitis.Alveolar sTREM-1 may be useful in separating infectious from noninfectious pulmonary aspiration and reduce injudicious antibiotic use.

DISCLOSURE:Ahmad Alhajhusain, No Financial Disclosure Information; No Product/Research Disclosure Information

Monday, October 27, 2008

10:30 AM - 12:00 PM


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