Heparin-binding protein in ventilator-induced lung injury

Heparin-Binding Protein in Bronchoalveolar Lavage Fluid as a Biomarker for Discriminating Severe Bacterial and Viral Pneumonia in Critically Ill Children

Objective

This study is aimed at exploring the ability to use heparin-binding protein (HBP) in bronchoalveolar lavage fluid (BALF) to differentially diagnose bacterial infection from viral infection for severe community-acquired pneumonia (CAP) in critically ill children.

Methods

A total of 181 children with severe CAP admitted to the intensive care unit (ICU) were included in this study. BALF and blood samples were collected within the first 24 hours of admission. BALF HBP and interleukin-6 (IL-6) concentrations and neutrophil percentage (N%) as well as blood HBP, IL-6, procalcitonin (PCT), C-reactive protein, white blood cell concentrations and N% were measured.

Results

Of the enrolled children, 126 were confirmed to have bacterial pneumonia, and 55 were confirmed to have viral pneumonia. Blood HBP and PCT concentrations and N% and BALF HBP and IL-6 concentrations and N% were significantly higher in bacterial pneumonia than in viral pneumonia (P < 0.05). In the bacterial pneumonia group, HBP and IL-6 concentrations and N% in BALF samples were all significantly higher than those in blood samples (P < 0.001), and BALF HBP and IL-6 concentrations and N% were correlated with blood HBP and IL-6 concentrations and N%, respectively (r = 0.439, 0.250, and 0.235, P < 0.01). BALF N% and blood N% were both correlated with BALF HBP concentrations and blood HBP concentrations, respectively (r = 0.622 and 0.346, P < 0.001). ROC analysis revealed that BALF HBP showed the best ability to predict bacterial pneumonia, with an area under the curve of 0.994, a sensitivity of 95.24%, and a specificity of 100.00% at its optimal cutoff value of 74.05 ng/mL.

Conclusion

BALF HBP might be a promising biomarker for the early discrimination of bacterial infection from viral infection in critically ill children with severe CAP.

Heparin-Binding Protein: A Novel Biomarker Linking Four Different Cardiovascular Diseases

Cardiovascular diseases are an important group of diseases that seriously affect quality of life. Thus, their treatment warrants further study. Heparin-binding protein (HBP) is a granulocyte protein derived from neutrophils. When an infection occurs, neutrophils release HBP, which can lead to elevated HBP levels in the blood. Therefore, HBP family members are said to be important indicators of infection. However, basic evidence is still lacking to confirm the possible relationship between HBP and cardiovascular diseases. Using bioinformatics methods, we investigated the role of the HBP network in normal hearts and hearts from patients with cardiovascular disease. First, we used the Open Targets database to obtain a list of HBP-encoding mRNAs related to atherosclerosis, myocarditis, myocardial infarction, and myocardial ischemia. Then, we constructed an HBP gene interaction network map using STRING. Clustering coefficients were calculated using Cytoscape, and MCODE was used for subnet analysis. Finally, the proposed interstitial network of HBPs was established and analyzed by Metascape enrichment analysis of the relevant signaling pathways. The aggregation coefficient of the HBP interaction network was higher among hearts with the four cardiovascular diseases, atherosclerosis (0.496), myocarditis (0.631), myocardial infarction (0.532), and myocardial ischemia (0.551), than in normal hearts. Metascape analysis showed that "NABA_MATRISOME_ASSOCIATED" was a typical pathway with the highest p value associated with epithelialization in all four diseases. Moreover, a large number of important HBPs were identified that may be significant for the treatment of these diseases. Therefore, HBPs do have a highly atopic connectivity network in cardiovascular diseases, and specific HBPs or signaling pathways may be used as targets for the development of new treatments for cardiovascular diseases.