Kit Name : Joinstar Heparin binding protein Detection Kit
Method: fluorescence dry quantitative immunoassay
Assay measuring range: 5.9ng/mL ~ 300.00ng/mL
Incubation time: 18min
Sample: human plasma (1:9 Sodium citrate),
Reference range: <11.4ng/mL
Storage and Stability:
✭Detection Buffer is stable for 12 months at 2°C ~8°C.
✭Sealed Test Device is stable for 12 months at 4°C～30°C.
• HBP, also known as asplenkillin or CAP37, is present in neutrophil anilinophil blue granules and secretory vesicles and was first isolated in 1984 by Shafer et al.
• The level of HBP in healthy people is extremely low, and once the body is infected, the pathogen rapidly stimulates neutrophils to release HBP with a half-life of only 1 hour.
• The released HBP has three major effects: bactericidal, chemotactic, and vascular leakage inducing effects.
Figure 1. HBP causes vascular leakage in hamsters
Left: Microscopic view of the hamster buccal sac microcirculation before HBP injection
• 《China Expert Consensus on Early Prevention and Interruption of Sepsis in Emergency Care 2020》
It has been shown that HBP is significantly elevated in patients with sepsis when IL-6 levels are normal or mildly elevated, and its accuracy in diagnosing sepsis is greater than that of other cytokines, especially in the early and rapid diagnosis of severe bacterial infections.
HBP, as an acute temporal protein, is an effective biomarker for assessing the severity of disease in patients with sepsis, and is more important in the early diagnosis and monitoring of the outcome of patients with septic shock.
As an acute temporal protein, HBP is an effective biomarker for assessing the severity of disease in septic patients and is even more important in the early diagnosis and monitoring of the efficacy of septic shock patients.
• 《Chinese Guidelines for the Treatment of SevereSepsis/Septic Shock (2014)》
Heparin binding protein is a useful indicator for the early diagnosis of severe sepsis/septic shock in critically ill patients with suspected infection. Prospective studies have found that high levels of plasma heparin-binding protein in febrile patients help identify patients at risk for rapid progression to circulatory failure in sepsis. Our Meta-analysis of the four RCTs mentioned above found that heparin-binding protein had a sensitivity of 80% (95% CI = 76% to 84%) and a specificity of 81% (95% CI = 77% to 84%) with an AUC of 0.87 (95% CI = 0.86 to 0.88) for the diagnosis of sepsis, suggesting that heparin-binding protein is also a useful indicator for the early diagnosis of severe sepsis/septic shock in critically ill patients. AUC was 0.87 (95% CI = 0.86-0.88), suggesting that heparin binding protein is also a valid indicator for early diagnosis of severe sepsis/septic shock in critically ill patients.
• Infection Total Infection Management
Infection 24-48h monitoring: cytosis occurs in 89% of HBP after 30min of bacterial phagocytosis by neutrophils Consensus 2020 states that HBP is elevated earlier than IL-6 ; it is elevated more rapidly in bacterial infections and earlier as a predictor of sepsis.
ng PCI, the level of CK-MB was associated with impaired outcome.
Sepsis 12-24h monitoring: the Guidelines 2014 state that HBP has a higher sensitivity and specificity than PCT. And as an inducer of vascular leakage, closely related to the severity of infection; high sensitivity and specificity Inducer of vascular leakage
Septic shock 6-12h monitoring: control HBP levels, reduce its toxic effects, alleviate excessive vascular leakage, use leakage modulating drugs, and adjust the treatment plan in a timely manner. Guidance on drug use
• Organ Dysfunction Reduce the incidence of organ dysfunction
Prediction: The results of a European multicenter study (7 medical institutions in Sweden, Canada, and the United States) showed that HBP was elevated as early as 24 hours before the onset of organ dysfunction. Compared to other biomarkers, HBP was the best predictor of the occurrence of infection-related organ dysfunction with an area under the curve AUC of 0.8.
Intervention: HBP can cause vascular leakage and tissue edema, and its role as a causative factor is a potential target for heparin, albumin, and other drugs to treat organ dysfunction. Drugs such as neutrophil degranulation inhibitors, simvastatin, ti䂳sentan and dextran sulfate are effective in reducing the level of HBP in patients.
Binding HBP stabilizes PMN cell membrane and protects mucopolysaccharide on endothelial cell surface
• Organ Failure Boosts Organ Failure Survival Rate
Prognostic assessment/adjustment of treatment plan
It was found that plasma HBP concentrations were significantly higher in 28-day non-surviving sepsis patients at enrollment and at the last measurement during the 144-hour study period than in surviving sepsis patients. Patients with sepsis with HBP >15 ng/ml at enrollment had a fourfold higher 28-day mortality rate .
Meanwhile, HBP is positively correlated with the number of organ failures, and monitoring HBP levels can help the clinic to more accurately assess the organ failure of patients and adjust the treatment plan in a timely manner.