Prognosis of community acquired pneumonia (CAP): value of triggering receptor expressed on myeloid cells-1 (TREM-1) and other mediators of the inflammatory response

Cytokine. 2007 Jun;38(3):117-23. doi: 10.1016/j.cyto.2007.05.002. Epub 2007 Jul 30.


TREM-1 is an activating receptor expressed on the surface of neutrophils and mature monocytes when stimulated by bacteria or fungi, leading to amplification of the inflammatory response. Our objective is to analyze the prognostic value of serum sTREM-1 levels and other mediators of the inflammatory response, in patients hospitalized for CAP, and to compare its prognostic value with those of advanced age, pneumonia severity scores, Charlson index, nutritional status and severity of sepsis.

Methods: We included 226 patients with CAP, 145 males and 81 females, median age of 74 years. The following tests were performed: arterial blood gases and chest radiography, nutritional assessment, assessment of the severity of the sepsis, Pneumonia Severity Index (PSI) and CURB-65, and mediators of inflammation: TNF alfa, IL-6, IL-10, IL-1ra, LBP, sCD14, CRP, and sTREM-1. Mortality during admittance was defined as the sole end point.

Results: Twenty-eight of the two-hundred and twenty-six patients died (12.4%). On univariate analysis advanced age, dehydration, increased Na, low BMI, handgrip strength, serum albumin, prealbumin, IGF-1, lymphocyte count, conscious drowsiness, tachypnea, decreased PaO2, hypotension, creatinine, ASAT, LDH, severity of sepsis, a high PSI or CURB65, TNFalpha, IL-6, IL-10, IL-1ra, and sTREM-1 were related to mortality. Variables with an independent value were IGF-1, CURB-65, TREM-1, advanced age and IL-6.

Conclusions: This study confirms the usefulness of TREM-1 in the diagnosis and prognosis of patients with CAP, which is independent of advanced age, other inflammation markers such as IL-6, severity index for CAP such as CURB-65 or PSI, severity of sepsis and nutritional status including IGF-1.

MeSH terms

  • Acute-Phase Proteins
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism
  • Carrier Proteins / blood
  • Community-Acquired Infections / immunology*
  • Community-Acquired Infections / mortality
  • Female
  • Humans
  • Inflammation Mediators / blood*
  • Interleukin 1 Receptor Antagonist Protein / blood
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Lipopolysaccharide Receptors / blood
  • Male
  • Membrane Glycoproteins / blood*
  • Middle Aged
  • Multivariate Analysis
  • Pneumonia / immunology*
  • Pneumonia / mortality
  • Prognosis
  • Receptors, Immunologic / blood*
  • Triggering Receptor Expressed on Myeloid Cells-1
  • Tumor Necrosis Factor-alpha / blood


  • Acute-Phase Proteins
  • Carrier Proteins
  • IL10 protein, human
  • IL6 protein, human
  • Inflammation Mediators
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-6
  • Lipopolysaccharide Receptors
  • Membrane Glycoproteins
  • Receptors, Immunologic
  • TREM1 protein, human
  • Triggering Receptor Expressed on Myeloid Cells-1
  • Tumor Necrosis Factor-alpha
  • lipopolysaccharide-binding protein
  • Interleukin-10
  • C-Reactive Protein