Role of triggering receptor expressed on Myeloid Cells-1 (TREM-1) in the prognostic evaluation in bacterial endophthalmitis.

Abstract

Infectious endophthalmitis, a vision-threatening intraocular infection requires immediate diagnosis, especially in culture-negative cases. This study evaluates soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1) and sTREM-2 as potential diagnostic biomarkers for bacterial endophthalmitis using transcriptomic and protein-level analyses. Transcriptomic profiling of Pseudomonas aeruginosa-infected C57BL/6 mice at 24h post-infection revealed significant enrichment of immune pathways, including IL-1 and T-cell receptor signaling. Trem1 was notably upregulated, while Trem2 was downregulated, indicating distinct roles in immune activation. ELISA-based quantification of sTREM-1 and sTREM-2 was performed on 62 human vitreous samples (30 culture-positive, 17 culture-negative, 15 non-infectious controls). sTREM-1 levels were significantly elevated in infected samples (p&#xa0;<&#xa0;0.001), correlating strongly with clinical severity. A diagnostic cutoff of 446.72&#xa0;pg/mL yielded over 90% sensitivity and specificity, even in culture-negative cases. In contrast, sTREM-2 levels were suppressed in infected groups and showed limited standalone diagnostic value. These results identify sTREM-1 as a robust biomarker for bacterial endophthalmitis diagnosis and disease monitoring, while sTREM-2 may play a modulatory role in inflammation. Further studies could assess the combined utility of these markers to enhance diagnostic accuracy and guide clinical decision-making in infectious endophthalmitis.