Heparin-binding protein (HBP)
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Infectious diseases are a kind of diseases that seriously threaten human health. Sepsis is one of the infectious diseases with high mortality. Early diagnosis and treatment have an important effect on improving the efficacy and prognosis of sepsis. So the biggest challenge now is how to make a clear diagnosis of sepsis as soon as possible. This year, HBP has been proven to be one of the early diagnostic markers of sepsis.
Because HBP is mainly released by external stimulation by PMN, the level of HBP in healthy people's blood is very low, normally not more than 10 ng/ml. When an infection occurs, some bacteria invade into the blood vessels, and the bacteria or the toxins released by the bacteria will stimulate releasing HBP by neutrophils, which makes an increase of HBP in blood. HBP can reach 20-30 ng/ml when infection. In severe cases, it can exceed 100 ng/ml, even up to 1000 ng/ml. When the HBP level exceeds 1000 ng/ml, the patient is already in extreme danger and is at risk of dying at any time. Therefore, HBP can be used as a monitoring indicator in the ICU ward.
Compared with other traditional indicators, HBP has the advantages of high sensitivity, strong specificity, and high detectable rate of positive/negative. It also has advantages of early appearance, and the concentration is extremely high only in acute bacterial infections, while the concentration keeps low level when infectious viral and non-specific inflammation. Therefore, HBP is significantly better than traditional inflammatory indicators such as PCT, CRP and IL-6.
As an early diagnostic target, PCT is a diagnostic and therapeutic indicator for serious bacterial infections. It is currently used in laboratory and clinical applications; however, it is only produced when the body infection produces a systemic response,and its serum is normal or slightly increased when partly and chronically infection. This will not good for diagnosis of local infections. CRP, CRP is an acute phase protein. A variety of infections and non-infective factors can cause elevated CRP. The general inflammatory reaction takes 12 hours to detect, there is a delayed response and its specificity is not ideal, especially for those patients with inflammatory inflammation and infection.
IL-6, in sepsis, various cells (monocytes, endothelial cells, macrophages) are stimulated by endotoxin, TNF, IL to secrete IL-6, and initiate an effective inflammatory response. The level of IL-6 can diagnose infection and judge prognosis, but except bacterial infection, other non-infectious factors can also cause non-specific elevation of IL-6, so the value of IL-6 in the diagnosis of sepsis is limited.