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Bronchoalveolar lavage/blood ratio of surface TREM-1 on CD14-positive monocytes is diagnostic of ventilator-associated pneumonia
© Grover et al. 2011
- Published: 1 March 2011
- Positive Likelihood Ratio
- Leukocyte Activation
- Trigger Receptor
- Clinical Pulmonary Infection Score
- Neutrophilic Level
Biomarkers offer the possibility to speed up diagnosis of ventilator-associated pneumonia (VAP) and differentiate it from nonpulmonary infection. One such marker, the triggering receptor expressed on myeloid cells-1 (TREM-1), exists as a soluble protein and a surface receptor expressed on monocytes and neutrophils . The purpose of the study was to determine the diagnostic utility of surface TREM-1 levels in VAP.
Paired bronchoalveolar lavage (BAL) and blood were obtained from 25 VAP patients, 15 ventilated non-infected controls, 10 ventilated patients with nonpulmonary infection and 25 nonventilated controls. VAP diagnosis was by clinical pulmonary infection score (CPIS) and semiquantitative microbiology. BAL and blood monocytic and neutrophilic levels of surface TREM-1 and CD11b (leukocyte activation marker) were assessed using flow cytometry. Monocytes were CD14-positive. Soluble TREM-1, IL-1β, IL-6 and IL-8 were measured using ELISA. BAL dilution was corrected by urea assay.
The BAL/blood ratio of monocytic surface TREM-1 diagnoses VAP and differentiates pulmonary from nonpulmonary infection. CD14 and TREM-1 may have a role in the pathogenesis of VAP.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.