Early Prognostication in Retreatment Pulmonary Tuberculosis patients by serum soluble TREM-1 levels

Abstract Soluble Triggering receptor expressed on myeloid cells-1(sTREM-1) is a sensitive marker of inflammation, proven useful in sepsis and infectious diseases prognostication. In search for sensitive biomarkers of response to Pulmonary Tuberculosis (TB) treatment, and treatment endpoint definitions, the current study was designed in patients on TB retreatment regimen. Decline in serum sTREM-1 levels after one and three months of treatment indicated good prognosis with complete cure without relapse. Patients with significant increasing levels in 2nd follow-up (increase > 1000pg/ml), either relapsed or accumulated resistance during treatment, while those with slight increase got cured. Two patients with very high baseline levels (> 10,000pg/ml) died one to two years after treatment completion (one with Diabetes mellitus, other with no known comorbidity). Serum sTREM-1 levels could prognosticate disease outcomes at diagnosis or as early as first month of treatment initiation and prove to be the ideal treatment endpoint marker or raise alarm for sinister outcomes.