Clinical utility of heparin-binding protein as an acute-phase inflammatory marker in interstitial lung disease

Abstract

The role of heparin‐binding protein (HBP) as an acute inflammatory marker in acute exacerbations of interstitial lung disease (AE‐ILD) and some stable ILD patients is not well‐established. The significance of increasing HBP during an AE‐ILD is examined and the first attempt to incorporate HBP into the ILD evaluation system is made. Then, the benefit of HBP in AE‐ILD was investigated. ILD patients (n = 108) were divided into subgroups based on the phase and severity of the disease. Linear trends of HBP across subgroups were observed, and correlations with common inflammatory markers were examined. Further, the HBP detection was adopted between serum and bronchoalveolar lavage fluid (BALF). Imaging and pathology changes were evaluated using various scoring criteria and compared to HBP. The relationship between HBP with ventilation, fibrosis progression, and changes in arterial oxygen levels and inflammatory markers were investigated to understand the mechanistic pathways. HBP was significantly higher in patients with AE‐ILD at the early stage, compared to patients with ILD at the stable phase and its increase was both found in the serum and BALF. With the remission of the disease, there was a linear trend of progressive decline. HBP identified ILD patients who had co‐infections. HBP levels increased earlier than CRP, PCT, and SAA. HBP was associated with pulmonary levels of ventilation and lesions by radiology examination, and its levels were significantly worse in AE‐ILD patients. However, HBP did not show a correlation to the pathology quantitative evaluation. In conclusion, HBP could potentially evaluate the progression and prognosis of AE‐ILD. Because ILD patients are susceptible to infection, and since HBP can identify co‐infection, this marker would be of great clinical importance. HBP is possibly predictive of acute exacerbation.

Heparin-Binding Protein: A Prognostic Biomarker Associated with Severe or Complicated Community-Acquired Pneumonia in Children

“… 25 A previous study has demonstrated the predictive value of HBP for acute exacerbations of interstitial lung disease. 26 The mechanistic pathways were probably similar to pulmonary injury in CAP.…”

Clinical value of serum sTREM-1 and HBP levels in combination with traditional inflammatory markers in diagnosing hospital-acquired pneumonia in elderly

“…Patients with acute infection have significantly higher levels of HBP, when compared to patients with a stable disease. Furthermore, HBP has been shown to have higher accuracy, when compared to CRP and PCT, in detecting pulmonary infections in ILD [ 10 ] For patients with COVID-19 infection, HBP is significantly elevated, but this level is negatively correlated with oxygen saturation, creatinine and lactate levels. Moreover, it was reported that HBP is an independent risk factor for death within 28 days [ 22 ].…”

“…It was reported that HBP can directly kill both Gram-positive and Gram-negative bacteria, and further enhance bacterial clearance by attracting macrophages, lymphocytes, and even more neutrophils to the site of infection [ 8 ]. Hence, HBP was suggested as a novel and valuable biomarker for sepsis and interstitial lung disease complicated by infection [ 9 , 10 ].…”

Clinical value of serum sTREM-1 and HBP levels in combination with traditional inflammatory markers in diagnosing hospital-acquired pneumonia in elderly

“…Patients with acute infection have signi cantly higher levels of HBP, when compared to patients with a stable disease. Furthermore, HBP has been shown to have higher accuracy, when compared to CRP and PCT, in detecting pulmonary infections in ILD [10] For patients with covid-19 infection, HBP is signi cantly elevated, and its levels are negatively correlated with oxygen saturation, creatinine and lactate levels. Moreover, HBP has been found to be an independent risk factor for death within 28 days [21].…”

“…HBP has been shown to be able to directly kill both Gram-positive and Gram-negative bacteria, and further enhance bacterial clearance by attracting macrophages, lymphocytes, and even more neutrophils to the site of infection [8]. Hence, HBP has been suggested to be a novel and valuable biomarker in sepsis and interstitial lung disease complicated by infection [9,10].…”