A Promising Candidate: Heparin-Binding Protein Steps onto the Stage of Sepsis Prediction

Abstract

Sepsis is a systemic inflammatory response syndrome caused by infection. With high morbidity and mortality of this disease, there is a need to find early effective diagnosis and assessment methods to improve the prognosis of patients. Heparin-binding protein (HBP) is a granular protein derived from polynuclear neutrophils. The biosynthetic HBP in neutrophils is rapidly released under the stimulation of bacteria, resulting in increased vascular permeability and edema. It is reasonable to speculate that the HBP in plasma may serve as a novel diagnostic marker for sepsis, bacterial skin infection, acute bacterial meningitis, leptospirosis, protozoan parasites, and even some noncommunicable diseases. It implies that in the detection and diagnosis of sepsis, it will be possible to make relevant diagnosis through this new indicator in the future. In this review, we summarize the typical biological function of HBP and its latest research progress to provide theoretical basis for clinical prediction and diagnosis of sepsis.

Heparin-binding protein as a novel biomarker for sepsis-related acute kidney injury

“…Previous studies have shown the molecular pathomechanisms of HBP involved in vascular leakage, chemotaxis and inflammation in the course of sepsis, cardiac and respiratory failure and various infections. It has been identified not only as a promising diagnostic marker, but also has prognostic relevance for severity of disease (Yang et al, 2019). However, the purpose of this study was not to determine the role of GrA and HBP in the pathogenesis of AKI during sepsis, but to investigate their significance in AKI diagnosis.…”

Combined detection of procalcitonin, heparin‐binding protein, and interleukin‐6 is a promising assay to diagnose and predict acute pancreatitis

“…HBP, refers to granule proteins derived from neutrophils, has antimicrobial activity and active roles in inflammatory responses 19 . HBP is positively correlated with PCT levels and may therefore also serve as an indirect biomarker for early diagnosis of infection 20 . It has been studied in several acute diseases, such as acute kidney injury, 21 acute lung injury, 22 bacterial skin infection, 23 acute bacterial meningitis, 24 but rarely in AP.…”

“… 19 HBP is positively correlated with PCT levels and may therefore also serve as an indirect biomarker for early diagnosis of infection. 20 It has been studied in several acute diseases, such as acute kidney injury, 21 acute lung injury, 22 bacterial skin infection, 23 acute bacterial meningitis, 24 but rarely in AP. IL‐6 is one of the more well‐studied cytokines that rapidly decreases within 48 h unless severe infection persists.…”

Heparin-binding protein levels correlate with aggravation and multiorgan damage in severe COVID-19

“…Endothelial cells are the primary targets of HBP released in the circulation and this protein plays a major role in the mechanism of capillary leakage, while it amplifies inflammatory effects by inducing cytoskeletal rearrangement and resulting in increased permeability of the vascular endothelial barrier [17,19]. Antigens, inflammatory factors, cytokines and enzymes can stimulate PMN to release HBP by exocytosis [20,21]. Studies in sepsis have indicated that the sensitivity and specificity of HBP are varied, compared to C-reactive protein (CRP) or procalcitonin (PCT), as an independent predictor of clinical outcome in severe infection [22,23].…”