The Application of Soluble Triggering Receptor Expressed on Myeloid Cells-1 in Sepsis & Relevant Acute Kidney Injuries

Chinese PLA General Hospital (301 Hospital)

Status: Completed

Conditions: SIRS; Sepsis

Study type: Observational

Funder types: Other

Identifiers

NCT01333657

301PLAGH-20090923-001

2009BAI86B03 (Other Grant/Funding Number)

Details and patient eligibility

About

Triggering receptor expressed on myeloid cells-1 is a member of the immunoglobulin superfamily of receptors that is specifically expressed on the surfaces of monocytes and neutrophils.TREM-1 expression is increased in infectious diseases and is associated with the release of soluble TREM-1 (sTREM-1).There has been demonstrated that the value of plasma sTREM-1 levels as an indicator of sepsis was superior, although other studies reported that the value of sTREM-1 for diagnosing sepsis was inferior.An increasing number of studies indicate that there are increased levels of sTREM-1 in body fluid samples for the following diseases and conditions: sepsis, pneumonia, pleural effusion, septic arthritis, meningitis, peritonitis, and uterine cavity infection.

Inflammation is now believed to play a major role in the pathophysiology of AKI. It is hypothesized that the initial insult results in morphological and/or functional changes in vascular endothelial cells and/or in tubular epithelium in sepsis models. Then, leukocytes including neutrophils, macrophages, natural killer cells, and lymphocytes infiltrate into the injured kidneys and induce the generation of inflammatory mediators. Whether urine sTREM-1 could also be detected and its significance in sepsis and AKI has not been reported yet.

The present study focused on the value of serum & urine sTREM-1 for sepsis identification, severity and prognosis assessments, and potential sepsis-related AKI. We also made comparisons between sTREM-1 and WBC counts, serum CRP, serum PCT, urine output,CC SCr, and BUN among sepsis patients.

Enrollment: 104 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Male and female aged 18 years old and over;
2. clinically suspected infection;
3. fulfilled at least two criteria of systemic inflammatory response syndrome (a) core temperature higher than 38 °C or lower than 36 °C (b)respiratory rate above 20/min, or PCO2 below 32 mmHg (c) pulse rate above 90/min, and (d) white blood cell count greater than 12,000/μl or lower than < 4,000/μl or less than 10% of bands.

Exclusion criteria

Those who fulfilled one below:

• neutropenia (≤ 500 neutrophils/mm3)
• HIV infection, and
• patients or their relatives refused

Trial design

104 participants in 2 patient groups

SIRS

Description:

1. temperature \>38 ℃ or \<36℃; 2. pulse rate\>90 beats/min; 3. ventilatory rate\>20 breaths/min or hyperventilation with partial pressure of arterial carbon dioxide (PaCO2)\<32mmHg; 4. white blood cell count\>12,000μL-1 or \<4000μL-1 or \>10% immature cells

Sepsis

Description:

1. sepsis: SIRS plus infection; 2. severe sepsis: sepsis associated with organ dysfunction, hypoperfusion, or hypotension; 3. septic shock: sepsis with arterial hypotension, despite adequate fluid resuscitation.