HEPARIN-BINDING PROTEIN AS A DIAGNOSTIC AND PROGNOSTIC MARKER OF INFECTIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS Heparin-binding protein in adult patients
Main Article Content
Keywords
Heparin-binding protein, Diagnosis, Prognosis, Infectious disease, Sepsis, Organ failure
Abstract
Heparin-binding protein (HBP) is a granule protein derived from neutrophils, located in secretory vesicles and neutrophilic granules, also known as cationic antimicrobial protein of 37 kDa (CAP37) or azurocidin. This study evaluates the diagnostic and prognostic value of HBP levels in relation to infection, organ dysfunction, and mortality in adult patients. A systematic review and meta-analysis were conducted by searching PubMed, Web of Science, EMBASE, and the Cochrane Database from their inception through June 2024. Original studies assessing HBP levels' diagnostic and prognostic utility in predicting infection and disease severity in critically ill adult patients were included. The primary outcome was the diagnostic and predictive role of HBP in infection and severity. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to evaluate bias risk. A total of 56 studies involving 11,486 patients were included. Pooled analysis showed HBP had a sensitivity of 0.87 (95% CI, 0.82–0.91), specificity of 0.87 (95% CI, 0.79–0.92), and an AUC of 0.93 (95% CI, 0.91–0.95) for infection diagnosis. For prognostic assessment, sensitivity was 0.77 (95% CI, 0.74–0.80), specificity was 0.72 (95% CI, 0.68–0.76), and AUC was 0.81 (95% CI, 0.78–0.85). HBP outperformed procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) in diagnosing and predicting critical illness. No publication bias was detected. HBP demonstrates high sensitivity and specificity for diagnosing infections in critically ill adult patients. Additionally, it effectively predicts disease progression, including organ dysfunction and mortality, surpassing traditional biomarkers such as PCT, CRP, and WBC. All that cannot be true for subjects with severe neutropenia.
Keywords: Heparin-binding protein; Systematic review, Meta-analysis, Diagnosis, Prognosis, Infectious disease, Sepsis, Organ failure, Mortality.
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9. Fisher J, Linder A: Heparin-binding protein: a key player in the pathophysiology of organ dysfunction in sepsis. Journal of internal medicine 2017, 281(6):562-574. doi: 10.1111/joim.12604.
10. Linder A, Christensson B, Herwald H, Björck L, Akesson P: Heparin-binding protein: an early marker of circulatory failure in sepsis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2009, 49(7):1044-1050. doi: 10.1086/605563.
11. Pan T, Long GF, Chen C, Zhang HT, Wang JX, Ahaskar A, Chen HB, Wang DJ: Heparin-binding protein measurement improves the prediction of myocardial injury-related cardiogenic shock. BMC cardiovascular disorders 2020, 20(1):124. doi: 10.1186/s12872-020-01406-3.
12. Linder A, Åkesson P, Inghammar M, Treutiger CJ, Linnér A, Sundén-Cullberg J: Elevated plasma levels of heparin-binding protein in intensive care unit patients with severe sepsis and septic shock. Critical care (London, England) 2012, 16(3):R90. doi: 10.1186/cc11353.
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Apr 30, 2025
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Yang, W. and Dong, W. (2025) “HEPARIN-BINDING PROTEIN AS A DIAGNOSTIC AND PROGNOSTIC MARKER OF INFECTIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS: Heparin-binding protein in adult patients”, Mediterranean Journal of Hematology and Infectious Diseases, 17(1), p. e2025029. doi: 10.4084/MJHID.2025.029.
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