Evaluation of TREM-1, HLA-G5 and HLA-DR levels and their relationship in patients with sepsis and severe sepsis

Sepsis is defined as the systemic inflammatory response syndrome caused by infections. If focus of infection can not removed or treated appropriately it may progress to septic shock and multiple organ failure. Although improvements in healthcareand management, diagnosis or treatment of infectious diseases, inadequate or late diagnosis of sepsis still lead to increase the mortality. Therefore, until receiving the microbiological test results, methods that can discriminate the infectious and noninfectious conditions, help to clinicians for accurate and timely approach to the patients with sepsis. For this reason, different parameters have been investigated to date. Increased C- reactive protein and procalcitonin levels are helpful in sepsis, but the researches continue to investigate for new and more specific markers. In our study, we aimed to evaluate the levels of sTREM-1, sHLA-G5 and lymphocyte subtypes in patients with sepsis and severe sepsis. Thus, we intend to provide better understanding of the immunopathogenesis of sepsis, to demonstrate the value of these markers in early or differential diagnosis of sepsis. Twenty healthy control subjects and 20 patients diagnosed with sepsis and severe sepsis, were included the study. Before initiation of antimicrobial therapy, serum levels of sTREM-1 and sHLA-G5 levels measured with ELISA method; lymphocyte, monocyte, granulocyte, CD14+ monocyte, CD14+ HLA-DR+ cells, CD3+, CD3+ HLA DR+, CD4+ and CD8+ T-lymphocytes, CD19+ B-lymphocytes, NK and NK-T cell levels were measured by flowcytometry. In the patient group, CD14+ monocytes, CD3+ HLA-DR+ T-lymphocyte levels were found higher than the control group (p <0.05), there were no statistically significant differences between other lymphocyte subtypes (p> 0.05). sTREM-1 levels in the patient group were found higher than the control group (p<0.05). There were no significant differencesat the levels of sHLA-G5 between the patient and the control groups (p> 0.05). In conclusion, pathogenesis of sepsis is still not exactly understood, and there is no marker as a gold standard marker with high sensitivity and specificity in the diagnosis of sepsis. We believe that further studies containing larger number of patients will clarify the pathogenesis and help for rapid diagnosis of the sepsis.