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Increased levels of soluble triggering receptor expressed on myeloid cells-1 in patients with acute pancreatitis*

Yasuda, Takeo MD, PhD; Takeyama, Yoshifumi MD, PhD; Ueda, Takashi MD, PhD; Shinzeki, Makoto MD, PhD; Sawa, Hidehiro MD, PhD; Takahiro, Nakajima MD, PhD; Kamei, Keiko MD; Ku, Yonson MD, PhD; Kuroda, Yoshikazu MD, PhD; Ohyanagi, Harumasa MD, PhD

doi: 10.1097/CCM.0b013e31817b8824
Clinical Investigations

Objective: To determine the contribution of triggering receptor expressed on myeloid cells (TREM)-1 in acute pancreatitis (AP).

Design: Prospective study.

Setting: General intensive care unit at Kobe University Hospital.

Patients: Forty-eight patients with AP and seven patients as control.

Interventions: None.

Measurements and Main Results: We measured serum concentrations of soluble TREM-1 (sTREM-1) at the time of admission by enzyme-linked immunoadsorbent assay. Serum sTREM-1 levels increased significantly in AP (63 ± 11 pg/mL) and correlated with Ranson score (R = .628, p < .001) and Acute Physiology and Chronic Health Evaluation II score (R = .504, p < .001). Serum TREM-1 levels were higher in patients with early organ dysfunction (which occurred within 7 days after onset) than those without early organ dysfunction (101 ± 19 vs. 25 ± 4 pg/mL, p < .001). Incidences of early organ dysfunction in patients whose serum sTREM-1 levels were ≤40 and >40 pg/mL were 17% and 83%, respectively (p < .001). The usefulness of serum sTREM-1 in detecting early organ dysfunction was superior to that of C-reactive protein, interleukin-6, interleukin-8, Ranson score, and Acute Physiology and Chronic Health Evaluation II score. Serum sTREM-1 levels decreased with resolution of early organ dysfunction.

Conclusions: Serum sTREM-1 levels were significantly increased and correlated with disease severity and early organ dysfunction in patients with AP. Serum sTREM-1 level may be a useful marker for early organ dysfunction in AP.

From the Department of Surgery (TY, YT, TU, KK, HO), Kinki University School of Medicine, Osaka-sayama, Japan; and the Department of Surgery (MS, HS, NT, YK, YK), Kobe University Graduate School of Medical Sciences, Kobe, Japan.

Supported, in part, by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science, Sports and Culture of Japan, and a Grant-in-Aid for Scientific Research from the Ministry of Health, Labor and Welfare of Japan.

The authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail: yasudatk@surg.med.kindai.ac.jp

© 2008 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins