Accuracy of Heparin-Binding Protein in Diagnosing Sepsis: A Systematic Review and Meta-Analysis

Wu, Yi-Luen; Yo, Chia‐Hung; Hsu, Wan‐Ting; Qian, Frank; Wu, Billy; Dou, Qingli; Lee, Chien‐Chang

doi:10.1097/ccm.0000000000004738

Cited by 35 publications

(37 citation statements)

References 48 publications

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“…Heparin-binding protein (HBP) is also involved in the pathophysiology of severe bacterial infections and may have a role in their management [ 48 ]. A high level of HBP in plasma might be a useful diagnostic marker for detecting organ dysfunction among patients ranging from suspected infections to septic shock [ 49 ]. In clinical studies, high plasma HBP levels in patients with sepsis were associated with a higher early fluid balance, increased organ failure within 5 days, and higher 28-day mortality [ 50 ].…”

Section: Bio-mechanistic Relationship Between Hypoalbuminemia and Infmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

158

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Hypoalbuminemia is associated with the acquisition and severity of infectious diseases, and intact innate and adaptive immune responses depend on albumin. Albumin oxidation and breakdown affect interactions with bioactive lipid mediators that play important roles in antimicrobial defense and repair. There is bio-mechanistic plausibility for a causal link between hypoalbuminemia and increased risks of primary and secondary infections. Serum albumin levels have prognostic value for complications in viral, bacterial and fungal infections, and for infectious complications of non-infective chronic conditions. Hypoalbuminemia predicts the development of healthcare-associated infections, particularly with Clostridium difficile. In coronavirus disease 2019, hypoalbuminemia correlates with viral load and degree of acute lung injury and organ dysfunction. Non-oncotic properties of albumin affect the pharmacokinetics and pharmacodynamics of antimicrobials. Low serum albumin is associated with inadequate antimicrobial treatment. Infusion of human albumin solution (HAS) supplements endogenous albumin in patients with cirrhosis of the liver and effectively supported antimicrobial therapy in randomized controlled trials (RCTs). Evidence of the beneficial effects of HAS on infections in hypoalbuminemic patients without cirrhosis is largely observational. Prospective RCTs are underway and, if hypotheses are confirmed, could lead to changes in clinical practice for the management of hypoalbuminemic patients with infections or at risk of infectious complications.

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Section: Bio-mechanistic Relationship Between Hypoalbuminemia and Infmentioning

confidence: 99%

Hypoalbuminemia as Surrogate and Culprit of Infections

Wiedermann¹

2021

IJMS

158

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“…At present, there is no study on the relationship between HBP in amniotic uid and HCA, but there are many studies on the relationship between HBP and infection, and HBP is considered as a reliable index for predicting severe infection. A meta-analysis of HBP in predicting sepsis in critically ill patients showed that the sensitivity and speci city of HBP in the diagnosis of sepsis were 0.85 and 0.91, respectively [27]; Another study on the relationship between HBP and sepsis also found that it has high diagnostic value. In addition, the study pointed out that the secretory granules secreting HBP were rst mobilized after neutrophil activation, so the rise of HBP was prior to other infection indicators (WBC, C-reactive protein, procalcitonin, lactic acid) [28]; Furthermore, elevated CSF levels of HBP can distinguish patients with acute bacterial meningitis from patients with other central nervous system infections [29].…”

Section: Discussionmentioning

confidence: 99%

Heparin-binding Proteins in Amniotic Fluid: Predicter for Histological Chorioamnionitis?

Wang

Xiang

et al. 2021

Preprint

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Background: Histological chorioamnionitis (HCA) is a serious threat to fetal health during pregnancy, which is not easily detected due to the lack of clinical symptoms, and there is still a lack of effective predictors and diagnostic indicators. Heparin-binding protein (HBP), an antimicrobial protein secreted by neutrophils, is highly valuable in predicting a variety of infectious diseases and is expected to be an effective predictor of histological chorioamnionitis.Methods: A total of 100 full-term healthy pregnant women delivered by cesarean section (control group) and 51 randomly enrolled pregnant women (pathology group) were included in this study. Amniotic fluid was extracted at delivery for HBP concentration, and postpartum placental pathology was performed in the pathology group to clarify the diagnosis of HCA. The predictive value of HBP in amniotic fluid for HCA was determined by establishing the reference interval for HBP in normal population and the receiver operating characteristic (ROC) curve.Results: The 95% confidence interval (95% CI) for HBP concentration in the amniotic fluid of normal pregnant women was 0- 87.08 ng/ml, with a median of 6.41 ng/ml; HBP concentration in the amniotic fluid of pregnant women with HCA was significantly higher than that of controls (P < 0.001) and non-HCA pregnant women (P < 0.001). The ROC curve showed that when the cut-off value of HBP in amniotic fluid was 82.67 ng/ml, the corresponding sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) were 84.20%, 96.90%, 94.12%, 91.18% and 0.86 (P < 0.001, 95% CI 0.715-1.000), respectively. Discussion: HBP in amniotic fluid is a potential, good predictor of HCA. We will further to explore its clinical application value.

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“…Dysregulated HBP level may cause tissue edema, hypotension, and organ dysfunction[4]. In recent years, studies have revealed that HBP is related to the severity of sepsis and can be used as a biomarker[5, 6]. HBP docks on the surface of vascular endothelial cells (ECs) and causes rearrangement of cytoskeleton and vascular leakage through protein kinase C (PKC)[7] and rho kinase signaling pathways[8].…”

Section: Introductionmentioning

confidence: 99%

TGF-β-R2 is required for HBP induced acute lung injury and vascular leakage for TGF-β/Smad/Rho signaling pathway activation

Liu

Chen

Sun

et al. 2022

Preprint

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Heparin-binding protein (HBP), as a granule protein secreted by polymorphonuclear neutrophils (PMNs) participates in the pathophysiological process of sepsis. It has been reported that HBP is a biomarker of sepsis, which is related to the severity of septic shock and organ dysfunction. HBP binds to vascular endothelial cells as one of the primary target sites. However, it is still unclear whether HBP-binding protein receptors exist on the surface of ECs. The effect of HBP on vascular permeability in sepsis and its mechanism needs to be explored. We conducted in vivo and in vitro study. We demonstrated that HBP bound to transforming growth factor-β receptor type 2 (TGF-β-R2) as a ligand. GST pull-down analysis reveals that HBP mainly interacts with the extracellular domain of TGF-β-R2. HBP induced acute lung injury (ALI) and vascular leakage via activation of TGF-β/SMAD2/3 signaling pathway. Permeability assay suggests TGF-β-R2 is necessary for HBP-induced increased permeability. We also defined the role of HBP and its potential membrane receptor TGF-β-R2 in the blood-gas barrier in the pathogenesis of HBP-related ALI.

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Accuracy of Heparin-Binding Protein in Diagnosing Sepsis: A Systematic Review and Meta-Analysis

Cited by 35 publications

References 48 publications

Hypoalbuminemia as Surrogate and Culprit of Infections

Hypoalbuminemia as Surrogate and Culprit of Infections

Heparin-binding Proteins in Amniotic Fluid: Predicter for Histological Chorioamnionitis?

TGF-β-R2 is required for HBP induced acute lung injury and vascular leakage for TGF-β/Smad/Rho signaling pathway activation

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