Triggering receptor expressed on myeloid cells 1 (TREM1) is an immunoglobulin (Ig) superfamily transmembrane protein that, in humans, is encoded by the TREM1gene. TREM1 is constitutively expressed on the surface of peripheral blood monocytes and neutrophils, and upregulated by toll-like receptor (TLR) ligands; activation of TREM1 amplifies immune responses.
TREM1 forms a complex with transmembrane adaptor DAP12 and, upon TREM1 engagement, a protein tyrosine kinase Syk-mediated cascade of tyrosine phosphorylation is initiated, activating downstream mediators such as PLCγ, PI3K, and MAPK. This cascade promotes the release of inflammatory cytokines and/or chemokines by neutrophils and macrophages, as well as their migration.
Based on laboratory studies, TREM1 might be involved in development of atherosclerosis, non-alcoholic fatty liver disease (NAFLD), and ischemic stroke.
Cancer
TREM1 expression is higher in tumor vs non-tumor tissues, likely due to its expression by myeloid cells that infiltrate tumors. TREM1 is expressed by myeloid immune-suppressive cell populations such as monocytic myeloid-derived suppressor cells (mMDSC), tumor-associated neutrophils (TANs), and tumor associated macrophages (TAMs). These types of tumor-associated myeloid infiltrate correlate with shorter survival times of patients with solid tumors, and are likely to be the reason that not all tumors respond to checkpoint inhibitor therapy. Antibodies that target TREM1 are therefore being studied for use in treatment patients with tumors that do not respond to checkpoint inhibitor therapy.
Flow cytometric analyses of human tumor-infiltrating myeloid cells isolated from breast cancer, bladder cancer, endometrial cancer, head and neck squamous cell carcinoma, ovarian cancer, prostate cancer, and renal cell carcinoma tissues demonstrated that within tumors, TREM1 is enriched on myeloid subsets, including mMDSCs, TANs, TAMs. Single-cell immune profiling of stage III-C ovarian tumor specimens revealed that TREM1 is specifically expressed in TAM and monocytes in these tumors. Additional studies found high expression of TREM1 protein and TREM1 mRNA, respectively, in TAMs and monocytes in human tumors.
During inflammation, a soluble form of the molecule (sTREM1) accumulates in the circulation, and is a biomarker of inflammation. There is debate over whether sTREM1 is produced as a splice variant or as the results of proteolytic cleavage. sTREM1 acts as a decoy for the unknown TREM1 ligands, and thereby prevents TREM1 activation. sTREM1 has been studied as a biomarker of development of pneumonia, sepsis, inflammatory bowel diseases, and liver cirrhosis.
Model organisms
Model organisms have been used in the study of TREM1 function. A conditional knockout mouse line called Trem1tm1(KOMP)Vlcg was generated at the Wellcome Trust Sanger Institute. Male and female animals underwent a standardized phenotypic screen to determine the effects of deletion. Additional screens included immune phenotyping. Blockade of TREM1 protects mice against microbe-induced shock, indicating that it is an important regulator of the immune response.
Celsius Therapeutics is developing CEL383, an antibody inhibitor of TREM1, for treatment of inflammatory bowel disease. As of October 2023, CEL383 is being evaluated in a phase 1 trial in healthy volunteers.
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