Serum heparin binding protein as a prognostic biomarker in community acquired pneumonia: A prospective observational...

Community-acquired pneumonia (CAP) is a significant cause of morbidity and mortality (1). Heparin-binding protein (HBP), also known as azurocidin is a multifunctional granule-associated protein that is rapidly mobilized from migrating polymorphonuclear leukocytes (2). HBP demonstrates potential as an early biomarker for predicting disease severity; however, further studies are needed to validate its ability to predict ICU admission and the need for mechanical ventilation.

In this prospective observational study conducted at a tertiary care hospital in southern India, 50 adult patients diagnosed with CAP (per ATS guidelines) were enrolled, including 25 non-severe CAP and 25 Severe CAP (sCAP) patients alongside 25 healthy age and gender matched controls. Clinical data, Pneumonia Severity Index scores (PSI) and inflammatory biomarkers were recorded. Serum HBP levels were measured within 24 h of admission using Enzyme Linked Immunosorbent Assay (ELISA) method. Statistical analysis included Receiver Operating curves (ROC) and logistic regression.

Severe CAP patients had significantly higher serum HBP levels compared to non-severe CAP patients (969.963 ± 98.950 vs. 1178.175 ± 107.500, p < 0.001). Serum HBP levels positively correlated with clinical parameters like PSI score, ICU admission and need for mechanical ventilation. ROC analysis showed HBP (AUC 0.926) had strong prognostic accuracy, comparable to PSI (AUC 0.982). Notably, combining HBP with PSI improved the AUC to 0.985, outperforming combinations with CRP.

Heparin-Binding Protein (HBP) shows promise as an early prognostic biomarker in community-acquired pneumonia, providing additional predictive value beyond traditional severity scoring systems. Combining HBP measurements with clinical severity scores could improve risk stratification and assist in making informed ICU admission decisions (3,4).