Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2005; 11(47): 7473-7479
Published online Dec 21, 2005. doi: 10.3748/wjg.v11.i47.7473
Expression of triggering receptor on myeloid cell 1 and histocompatibility complex molecules in sepsis and major abdominal surgery
Nestor González-Roldán, Eduardo Ferat-Osorio, Rosalía Aduna-Vicente, Isabel Wong-Baeza, Noemí Esquivel-Callejas, Horacio Astudillo-de la Vega, Patricio Sánchez-Fernández, Lourdes Arriaga-Pizano, Miguel Angel Villasís-Keever, Constantino López-Macías, Armando Isibasi
Nestor González-Roldán, Eduardo Ferat-Osorio, Rosalía Aduna-Vicente, Isabel Wong-Baeza, Noemí Esquivel-Callejas, Lourdes Arriaga-Pizano, Constantino López-Macías, Armando Isibasi, Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), México
Horacio Astudillo-de la Vega, Laboratorio de Oncología Molecular, Unidad de Investigación Médica en Enfermedades Oncológicas, Hospital de Oncología, Centro Médico Nacional Siglo XXI, IMSS, México
Patricio Sánchez-Fernández, Servicio de Gastrocirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, México
Miguel Angel Villasís-Keever, Unidad de Investigación en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, IMSS, México
Author contributions: All authors contributed equally to the work.
Supported by Fondo para el Fomento de la Investigación Médica (FOFOI), Instituto Mexicano del Seguro Social
Correspondence to: Dr Armando Isibasi, Coordinación de Investigación en Salud, Unidad de Investigación Médica en Inmunoquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, P.O. Box A047, 06703, México. isibasi@prodigy.net.mx
Telephone: +52-55-56-27-69-15 Fax: +52-55-57-61-09-52
Received: April 30, 2005
Revised: July 1, 2005
Accepted: July 8, 2005
Published online: December 21, 2005
Abstract

AIM: To evaluate the surface expression of triggering receptor on myeloid cell 1 (TREM-1), class II major histocompatibility complex molecules (HLA-DR), and the expression of the splicing variant (svTREM-1) of TREM-1 in septic patients and those subjected to major abdominal surgery.

METHODS: Using flow cytometry, we examined the surface expression of TREM-1 and HLA-DR in peripheral blood monocytes from 11 septic patients, 7 elective gastrointestinal surgical patients, and 10 healthy volunteers. svTREM-1 levels were analyzed by RT-PCR.

RESULTS: Basal expression of TREM-1 and HLA-DR in healthy volunteers was 35.91±14.75 MFI and 75.8±18.3%, respectively. In septic patients, TREM-1 expression was 59.9±23.9 MFI and HLA-DR expression was 44.39±20.25%, with a significant difference between healthy and septic groups (P<0.05) for both molecules. In the surgical patients, TREM-1 and HLA-DR expressions were 56.8±20.85 MFI and 71±13.8% before surgery and 72.65±29.92 MFI and 72.82±22.55% after surgery. TREM-1 expression was significantly different (P = 0.0087) between the samples before and after surgery and svTREM-1 expression was 0.8590±0.1451 MF1, 0.8820±0.1460 MF1, and 2.210±0.7873 MF1 in the healthy, surgical (after surgery) and septic groups, respectively. There was a significant difference (P = 0.048) in svTREM-1 expression between the healthy and surgical groups and the septic group.

CONCLUSION: TREM-1 expression is increased during systemic inflammatory conditions such as sepsis and the postoperative phase. Simultaneous low expression of HLA-DR molecules correlates with the severity of illness and increases susceptibility to infection. Additionally, TREM-1 expression is distinctly different in surgical patients at different stages of the inflammatory response before and after surgery. Thus, surface TREM-1 appears to be an endogenous signal during the course of the inflammatory response. svTREM-1 expression is significantly increased during sepsis, appearing to be an indicator of severity of illness. Together, these data indicate that TREM-1 may play an important role in establishing and amplifying the systemic inflammatory response. TREM-1, HLA-DR, and svTREM-1 expression analysis can provide useful diagnostic and prognostic indicators during SIRS, CARS, and sepsis.

Keywords: TREM-1; HLA-DR; SIRS; CARS; Sepsis