{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T14:20:17Z","timestamp":1774016417446,"version":"3.50.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Acute kidney injury (AKI) is a potential complication after cardiopulmonary bypass (CPB) of pediatric cardiac surgery and contributes to a certain amount of perioperative mortality. Serum soluble triggering receptor expressed on myeloid cells2 (sTREM2) is an inflammation-associated cytokine in circulation. Alterations of sTREM2 level have been reported in Alzheimer's disease, sepsis, and some other pathologic conditions. This study aimed to investigate the role of sTREM2 as a forecasting factor for AKI in infants and young children and other factors associated with early renal injury after pediatric CPB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study with consecutive infants and young children\u2009\u2264\u20093 years old undergoing CPB from September 2021 to August 2022 was conducted in an affiliated university children's hospital. These patients were divided into an AKI group (<jats:italic>n<\/jats:italic>\u2009=\u200910) and a non-AKI group (<jats:italic>n<\/jats:italic>\u2009=\u200960). Children\u2032s characteristics and clinical data were measured. Perioperative sTREM2 levels were analyzed with enzyme-linked immunosorbent assay (ELISA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In children developing AKI, the sTREM2 levels significantly decreased at the beginning of CPB compared to the non-AKI group. Based on binary logistic regression analysis and multivariable regression analysis, risk-adjusted classification for congenital heart surgery (RACHS-1), operation time, and the s-TREM2 level at the beginning of CPB (AUC\u2009=\u20090.839, <jats:italic>p<\/jats:italic>\u2009=\u20090.001, optimal cut-off value: 716.0\u2005pg\/ml) had predictive value for post-CPB AKI. When combining the sTREM2 level at the beginning of CPB and other indicators together, the area under the ROC curve enlarged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Operation time, RACHS-1 score, and sTREM2 level at the beginning of CPB were independent prognosis factors of post-CPB AKI in infants and young children\u2009\u2264\u20093 years old. Decreased sTREM2 identified post-CPB AKI, and ultimately hampered the outcomes. Our findings indicated that sTREM2 may be a protective factor for AKI after CPB in infants and young children\u2009\u2264\u20093 years old.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1185151","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T07:34:22Z","timestamp":1687764862000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Serum soluble triggering receptor levels expressed on myeloid cells2 identify early acute kidney injury in infants and young children after pediatric cardiopulmonary bypass"],"prefix":"10.3389","volume":"11","author":[{"given":"Mingwei","family":"Sun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Zong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liyang","family":"Ying","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiwang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ru","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s40560-017-0242-z","article-title":"AKI After 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after pediatric cardiopulmonary bypass","volume":"32","author":"Dong","year":"2017","journal-title":"Pediatr Nephrol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.cell.2017.07.023","article-title":"TREM2 Maintains microglial metabolic fitness in Alzheimer's Disease","volume":"170","author":"Ulland","year":"2017","journal-title":"Cell"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e135197","DOI":"10.1172\/JCI135197","article-title":"TREM2 Sustains macrophage-hepatocyte metabolic coordination in nonalcoholic fatty liver disease and sepsis","volume":"131","author":"Hou","year":"2021","journal-title":"J Clin Invest"},{"key":"B7","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1186\/s12974-020-01878-2","article-title":"TREM2 Ectodomain and its soluble form in Alzheimer's Disease","volume":"17","author":"Yang","year":"2020","journal-title":"J 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ischemia\/reperfusion injury","volume":"10","author":"Wu","year":"2017","journal-title":"Mol Brain"},{"key":"B18","doi-asserted-by":"publisher","first-page":"616044","DOI":"10.3389\/fimmu.2020.616044","article-title":"Trem2 promotes emergence of restorative macrophages and endothelial cells during recovery from hepatic tissue damage","volume":"11","author":"Coelho","year":"2021","journal-title":"Front Immunol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1097\/SHK.0000000000001668","article-title":"Triggering receptor expressed on myeloid cells-2 protects aged mice against sepsis by mitigating the IL-23\/IL-17A response","volume":"56","author":"Chen","year":"2021","journal-title":"Shock"}],"container-title":["Frontiers in 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