Expression And Clinic Significance Of Human Triggering Receptor Expressed On Myeloid Cells (TREM)-1 In Acute Cholangitis

Objects: The triggering receptor expressed on myeloid cells (TREM)-1 is a recently discovered member of the immunoglobulin superfamily which is a new diadynamic criterion of inflammation reaction in the early stage. Acute cholangitis is one of the common diseases in surgical abdomens and is also troublesome disease in hepatobiliary surgery, it can induce most organs dysfunction and failure. This research investigate the expression level of human TREM-1 mRNA and protein in patients with acute cholangitis induced by choledocholith between preoperative and 4postoperative, and compare the relationship of TREM-1, tumor necrosis factor (TNF-α) or C reactive protein (CRP) during the onset and recovery of acute cholangitis, and discuss the express regularity or clinical significance of TREM-1 in acute cholangitis, especially in acute cholangitis of severe type.Methods: peripheral blood monouclear cells(PBMC) of 48 patients with acute cholangitis of severe type (ACST group), 42 patients with acute cholangitis (AC group) and 40 health controls were collected respectively. TREM-1 mRNA in PBMC was determined by RT-PCR and its protein level was determined by immunocytochemistry and Western Blotting. Elisas were employed to detect TNF-α. CRP was determined by Immunityturbidimetry. We compared their express regularity and relationship between preoperative and postoperative. All statistical analyses were completed with SPSS 13.0 version software. Descriptive results were reported as mean±SD. All data were analyzed with Student's t-,χ2 tests and ANOVA, then statistical treatment.Results:1. It has been shown in RT-PCR that the express level of TREM-1 mRNA in PBMC in ACST group and AC group at preoperative were 0.812±0.041和0.983±0.096, respectively, the express level of TREM-1 mRNA in PBMC in both groups was higher than in controls, and the mRNA express level was obviously higher in ACST group than in AC group (P<0.05). TREM-1 mRNA expression levelat in PBMC in AC group and ACST group at postoperative 48 hours were 0.572±0.007 and 0.711±0.051, respectively. The mRNA express level in PBMC in both groups was down-regulated (P<0.05).2. In Immunocytochemistry, there was no dyeing cell in the controls; while TREM-1 positive express rate in AC group and ACST group at preoperatively were 85.71% and 100%, respectively. At postopetative 48 hours, the positive express rate of both groups were 35.71% and 43.75%, respectively, and its express down-regulated at postoperative (P<0.05). These results were similar to those in RT-PCR.3. This research demonstrated by Western Blotting that, the express level of TREM-1 protein in PBMC in AC group and ACST group at preoperative were 734±0.042和0.832±0.053, respectively, the express level of TREM-1 protein in PBMC was higher in ACST group than in AC group (P<0.05). The express level of TREM-1 protein in PBMC in AC group and ACST group at postoperative 48h were 0.456±0.012 0.584±0.032, respectively, and its express down-regulated at postoperative 48 hours in both groups.4. Correlation analysis found that TREM-l expression was closely related with TNF-αand CRP expression, the correlation coefficients were r1=0.712 and r2=0.701, respectively (P<0.01).Conclusions: Expression of human TREM-1 up-regulated obviously in patients with AC and ACST in the early stage. TREM-1 may be a useful index to judge degree of pathogenetic condition in pyaemia patients.