Caracterización de la expresión de nCD64 en neutrófilos y de los niveles de s-TREM-1 y HMGB-1 en pacientes con sospecha de infección admitidos en el departamento de emergencias

Abstract

Introduction:The nCD64 receptor, the soluble triggering receptor expressed in myeloid cells (s-TREM-1), and the high mobility group-box 1 protein (HMGB-1) have been proposed as significant mediators in sepsis. Objective: To evaluate the prognostic value of these markers in patients with suspected infection recently admitted in an emergency department (ED). Materials and methods:All patients who presented to the ED with suspected infection were eligible for enrollment in this study. Baseline clinical data, Sequential Organ Failure Assessment score (SOFA) score, APACHE II score, HMGB-1 levels, s-TREM-1 levels, and nCD64 levels were analyzed. The HMGB-1 and sTREM-1 serum concentrations were determined using commercially available ELISA kits, and CD64 on the surface of neutrophils was measured by flow cytometry. Results:. A total of 579 patients with suspected infection as their admission diagnosis were enrolled in this study. The median patient age was 50 years (IQR = 35-68). Morbidity during the 28-day followup period was 11.1% (n=64). The most frequent diagnosis at the time of admission was communityacquired pneumonia (CAP) in 23% (n=133) patients, followed by soft tissue infection in 16.6% (n=96), and urinary tract infection in 15% (n=87). After multivariable analysis, no significant association was identified between any biomarker and 28-day mortality. Conclusion:In the context of a tertiary care hospital emergency department in a Latin-American city, the nCD64 receptor, s-TREM-1, and HMGB-1 biomarkers do not demonstrate prognostic utility in the management of patients with infection. The search continues for more reliable prognostic markers in the early stages of infection.

Human immunoglobulin in combination with antimicrobial agents enhances the treatment efficacy and reduces inflammatory response in children with severe pneumonia

“…This study suggests that the use of human immunoglobulin in the treatment of pediatric severe pneumonia can regulate the Th1/Th2 balance and avoid excessive activation of Th2. [31][32][33][34][35][36][37]. The results of this study showed that the levels of IL-6, IL-8 and hsCRP in the peripheral blood of both groups were significantly lower than those before treatment, and the levels in the observation group were significantly lower than those in the control group.…”

Association of decreased serum sTREM-1 level with the severity of coronary artery disease

“…[14,15] Soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) proteins are detected in patients suffering from severe infectious diseases including pneumonia, sepsis, and chronic bowel disease. [16,17] Elevated level of sTREM-1 is associated with the disease severity and adverse outcome in patients with sepsis and lower respiratory tract infection. [18,19] …”