Diagnostic value of soluble triggering receptor expressed on myeloid cells in paediatric sepsis: a systematic review

Pontrelli, Giuseppe; Crescenzo, Franco De; Buzzetti, Roberto; Carducci, Francesca Calò; Jenkner, Alessandro; Amodio, Donato; Luca, Maia De; Chiurchiù, Sara; Davies, Elin Haf; Simonetti, Alessandra; Ferretti, Elena; Corte, Martina Della; Gramatica, Luca; Livadiotti, Susanna; Rossi, Paolo

doi:10.1186/s13052-016-0242-y

Cited by 23 publications

(15 citation statements)

References 27 publications

(42 reference statements)

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“…According to some authors, sTREM-1, when used as a single marker, has an insufficient diagnostic value in the differentiation of sepsis from fever unrelated to bacteremia [34]. Pontrelli et al, based on a meta-analysis of 9 studies including 961 patients, showed that sTREM-1 is not a sufficiently sensitive and specific diagnostic marker of sepsis in children [35]. In our own study, sTREM-1 was also not useful in SIRS/sepsis diagnosis among feverish children, which may…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Prognostic Value of IL-6 and sTREM-1 in SIRS and Sepsis in Children

Smok

Domagalski

Pawłowska

2020

Mediators of Inflammation

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Purpose. The aim of this study was to evaluate the diagnostic and prognostic value of IL-6 and sTREM-1 in the course of SIRS and sepsis in children with reference to routinely used CRP and PCT. Methods. A prospective study included 180 patients at the ages from 2 months to 18 years hospitalized due to fever from November 2015 to January 2017. Forty-nine children without fever hospitalized due to noninfectious causes formed the control group. IL-6 and sTREM-1 serum concentrations were assessed with the enzyme-linked immunosorbent assay method. Results. The mean serum concentrations of all the analyzed biomarkers were statistically significantly higher in the study group compared to the control group. Mean IL-6, sTREM-1, and PCT serum concentrations were statistically significantly higher in the group of patients with SIRS/sepsis compared to the group of feverish patients without diagnosed SIRS (N-SIRS). Based on the ROC curve analysis, it was shown that of all the biomarkers tested, only two—IL-6 and procalcitonin—had potential usefulness in the diagnosis of SIRS/sepsis in children with fever. Conclusion. Elevated levels of IL-6 and PCT are important risk factors for the development of SIRS/sepsis in children with fever. It seems that elevated IL-6 baseline serum level may predict a more severe course of febrile illness in children, because based on the ROC curve analysis, it was found that IL-6 is a statistically significant prognostic marker of prolonged fever≥3 days and prolonged hospitalization>10 days. The assessment of the usefulness of sTREM-1 in the diagnosis of SIRS/sepsis in feverish children requires further research.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and Prognostic Value of IL-6 and sTREM-1 in SIRS and Sepsis in Children

Smok

Domagalski

Pawłowska

2020

Mediators of Inflammation

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“…sTREM-1, a member of the immunoglobulin superfamily, is a soluble TREM-1 that is upregulated when neutrophils are exposed to bacteria, but not during noninfectious in ammatory diseases, which suggests that sTREM-1 may be a speci c marker for infectious diseases [10][11][12]. Previous research has demonstrated that sTREM-1 yielded a high sensitivity (> 95%) and speci city (> 85%) in systemic in ammatory response syndrome patients [13,14], and may be more useful than C-reactive protein and procalcitonin with regard to sepsis diagnosis in adult and pediatric patients [15,16].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of bronchoalveolar lavage-fluid soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) concentration for neonatal ventilator-associated pneumonia

Zhou¹,

Zhou²,

Hong

et al. 2020

Preprint

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Background: Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) has regarded as a biological marker of infection.We aimed to evaluate the diagnostic value of bronchoalveolar lavage (BAL)-sTREM-1 concentration in neonatal ventilator-associated pneumonia (NVAP).Methods: In this multicenter, controlled clinical trial of 60 preterm and 33 full-term neonates on mechanical ventilators, we measured concentrations of BAL-fluid and serum sTREM-1, serum C-reactive protein, and serum procalcitonin, as well as white blood cell count. We initially divided cases into eight groups, based on three categories: preterm of full-term; NVAP or non-NVAP; and extrapulmonary infection present or absent. Groups were compared, and logistic regression analysis and receiver operating characteristic (ROC) analysis was performed to determine diagnostic value.Results: The mean gestational age (± standard deviation) of preterm and full-term neonates was 28.9±2.2 weeks and 39.5±1.7 weeks, respectively, and 32/60 were male. The BAL-fluid sTREM-1 concentration was higher in NVAP cases than in non-NVAP cases, irrespective of extrapulmonary infection. ROC analysis revealed that BAL-fluid sTREM-1 concentration had an area under the curve (AUC) of 0.986 and a cutoff value of 228.0 pg/ml (sensitivity, 94.3%; specificity, 96%) in preterm neonates; the same values in full-term neonates were 0.938 and 245.5 pg/ml (sensitivity, 100%; specificity, 93.7%), respectively. The optimal combination of indicators was BAL-fluid sTREM-1 and serum C-reactive protein concentration. All indicators were present at lower levels on days 8 and 10 of ventilation in neonates who ultimately recovered than in those who did not. Conclusions: BAL-fluid sTREM-1 and serum C-reactive protein concentrations may be useful for the diagnosis of NVAP.Blinded manuscript textThe RCT was approved by the Ethics Review Committee ofThe First People's Hospital of Yongkang (number: ykyy201803). Furthermore, the study was registered in and approved by the Registration Centre of Clinical Trials in China (approval number: ChiCTR1900020564). URL of trial registry record:http://www.chictr.org.cn/showproj.aspx?proj=22336 Date of registration:2017-10-19

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“…A systematic review identified nine studies containing 961 patients [105]. Due the difference in study designs and populations (four studies in neonates, two in paediatrics and two in paediatrics specifically with neutropaenia) meta-analysis of the data was not possible; some of the data indicated a potential role for sTREM-1 as a biomarker of sepsis, although no strong conclusions could be drawn.…”

Section: Neonatesmentioning

confidence: 99%

“…The lack of pre-specified diagnostic cut-offs was also evident in neonatal studies [102], which was also compounded by differences in the classification of neonatal sepsis, which were both noted as limitations of their meta-analysis. Differing diagnostic cut-off values have also been suggested for sTREM-1, with a range of 1.25 to 525pg/mL found in the studies considered by Pontrelli and co-workers [105]. They further stated that there should be an effort to standardise analytical methods in order to enable the comparison of results between studies.…”

Section: Biomarker Diagnostic Cut-off Valuesmentioning

confidence: 99%

Biomarkers for Point-of-Care Diagnosis of Sepsis

2020

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Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In 2017, almost 50 million cases of sepsis were recorded worldwide and 11 million sepsis-related deaths were reported. Therefore, sepsis is the focus of intense research to better understand the complexities of sepsis response, particularly the twin underlying concepts of an initial hyper-immune response and a counter-immunological state of immunosuppression triggered by an invading pathogen. Diagnosis of sepsis remains a significant challenge. Prompt diagnosis is essential so that treatment can be instigated as early as possible to ensure the best outcome, as delay in treatment is associated with higher mortality. In order to address this diagnostic problem, use of a panel of biomarkers has been proposed as, due to the complexity of the sepsis response, no single marker is sufficient. This review provides background on the current understanding of sepsis in terms of its epidemiology, the evolution of the definition of sepsis, pathobiology and diagnosis and management. Candidate biomarkers of interest and how current and developing point-of-care testing approaches could be used to measure such biomarkers is discussed.

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Diagnostic value of soluble triggering receptor expressed on myeloid cells in paediatric sepsis: a systematic review

Cited by 23 publications

References 27 publications

Diagnostic and Prognostic Value of IL-6 and sTREM-1 in SIRS and Sepsis in Children

Diagnostic and Prognostic Value of IL-6 and sTREM-1 in SIRS and Sepsis in Children

Diagnostic value of bronchoalveolar lavage-fluid soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) concentration for neonatal ventilator-associated pneumonia

Biomarkers for Point-of-Care Diagnosis of Sepsis

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