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Published in: Digestive Diseases and Sciences 10/2021

01-10-2021 | Acute Pancreatitis | Original Article

Heparin-Binding Protein Levels at Admission and Within 24 h Are Associated with Persistent Organ Failure in Acute Pancreatitis

Authors: Wenqing Shu, Jianhua Wan, Xiaoyu Yang, Jie Chen, Qinyu Yang, Fen Liu, Liang Xia

Published in: Digestive Diseases and Sciences | Issue 10/2021

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Abstract

Background

Identification of patients at risk for persistent organ failure (POF) early in the course of acute pancreatitis (AP) is critical for early intervention. Heparin-binding protein (HBP) levels are closely related to inflammation. Therefore, we investigated the relationship between HBP levels and POF in patients with AP.

Methods

This observational cohort study analyzed 66 patients with AP and 14 healthy volunteers between June 2019 and December 2019. Baseline characteristics, laboratory data, and severity scores of patients with different degrees of AP were compared. Levels of HBP were measured by ELISA. Serum HBP levels were analyzed using receiver operating characteristic curves to identify POF in AP.

Results

Concentrations of serum HBP in healthy volunteers, MAP, MSAP, and SAP groups were 3.9 (range: 3.4–5) ng/ml, 5.2 (3.9–6.8) ng/ml, 5.9 (4.6–7.7) ng/ml, and 11 (8.0–13.8) ng/ml, respectively. The level of HBP in SAP patients was significantly elevated compared to the other groups (P < 0.01). HBP levels ≥ 7 ng/ml showed a specificity of 74%, a sensitivity of 90%, and an AUC of 0.82 for predicting POF.

Conclusions

HBP levels in patients with POF were significantly elevated. HBP is a useful marker for predicting severe AP.
Literature
1.
go back to reference Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111.CrossRef Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111.CrossRef
2.
go back to reference Guo Q, Li A, Xia Q, et al. The role of organ failure and infection in necrotizing pancreatitis: a prospective study. Ann Surg. 2014;259(6):1201–1207.CrossRef Guo Q, Li A, Xia Q, et al. The role of organ failure and infection in necrotizing pancreatitis: a prospective study. Ann Surg. 2014;259(6):1201–1207.CrossRef
3.
go back to reference Petrov MS, Shanbhag S, Chakraborty M, et al. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139(3):813–820.CrossRef Petrov MS, Shanbhag S, Chakraborty M, et al. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology. 2010;139(3):813–820.CrossRef
4.
go back to reference Fisher JM, Gardner TB. The “golden hours” of management in acute pancreatitis. Am J Gastroenterol. 2012;107(8):1146–1150.CrossRef Fisher JM, Gardner TB. The “golden hours” of management in acute pancreatitis. Am J Gastroenterol. 2012;107(8):1146–1150.CrossRef
5.
go back to reference Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400–1415.CrossRef Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol. 2013;108(9):1400–1415.CrossRef
6.
go back to reference Ranson JH, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69–81.PubMed Ranson JH, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69–81.PubMed
7.
go back to reference Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson’s, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol 2010; 105(2):435–41; quiz 442. Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson’s, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroenterol 2010; 105(2):435–41; quiz 442.
8.
go back to reference Mounzer R, Langmead CJ, Wu BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology 2012; 142(7):1476–82; quiz e15-6. Mounzer R, Langmead CJ, Wu BU, et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology 2012; 142(7):1476–82; quiz e15-6.
9.
go back to reference Koutroumpakis E, Wu BU, Bakker OJ, et al. Admission hematocrit and rise in blood urea nitrogen at 24 h outperform other laboratory markers in predicting persistent organ failure and pancreatic necrosis in acute pancreatitis: a post hoc analysis of three large prospective databases. Am J Gastroenterol. 2016;111(8):1216.CrossRef Koutroumpakis E, Wu BU, Bakker OJ, et al. Admission hematocrit and rise in blood urea nitrogen at 24 h outperform other laboratory markers in predicting persistent organ failure and pancreatic necrosis in acute pancreatitis: a post hoc analysis of three large prospective databases. Am J Gastroenterol. 2016;111(8):1216.CrossRef
10.
go back to reference Abdulla A, Awla D, Thorlacius H, Regner S. Role of neutrophils in the activation of trypsinogen in severe acute pancreatitis. J Leukoc Biol. 2011;90(5):975–982.CrossRef Abdulla A, Awla D, Thorlacius H, Regner S. Role of neutrophils in the activation of trypsinogen in severe acute pancreatitis. J Leukoc Biol. 2011;90(5):975–982.CrossRef
11.
go back to reference Madhi R, Rahman M, Taha D, et al. Platelet IP6K1 regulates neutrophil extracellular trap-microparticle complex formation in acute pancreatitis. JCI Insight 2019. Madhi R, Rahman M, Taha D, et al. Platelet IP6K1 regulates neutrophil extracellular trap-microparticle complex formation in acute pancreatitis. JCI Insight 2019.
12.
go back to reference Merza M, Hartman H, Rahman M, et al. Neutrophil extracellular traps induce trypsin activation, inflammation, and tissue damage in mice with severe acute pancreatitis. Gastroenterology. 2015;149(7):1920–1931.e8.CrossRef Merza M, Hartman H, Rahman M, et al. Neutrophil extracellular traps induce trypsin activation, inflammation, and tissue damage in mice with severe acute pancreatitis. Gastroenterology. 2015;149(7):1920–1931.e8.CrossRef
13.
go back to reference Linder A, Arnold R, Boyd JH, et al. Heparin-binding protein measurement improves the prediction of severe infection with organ dysfunction in the emergency department. Crit Care Med. 2015;43(11):2378–2386.CrossRef Linder A, Arnold R, Boyd JH, et al. Heparin-binding protein measurement improves the prediction of severe infection with organ dysfunction in the emergency department. Crit Care Med. 2015;43(11):2378–2386.CrossRef
14.
go back to reference Gautam N, Olofsson AM, Herwald H, et al. Heparin-binding protein (HBP/CAP37): a missing link in neutrophil-evoked alteration of vascular permeability. Nat Med. 2001;7(10):1123–1127.CrossRef Gautam N, Olofsson AM, Herwald H, et al. Heparin-binding protein (HBP/CAP37): a missing link in neutrophil-evoked alteration of vascular permeability. Nat Med. 2001;7(10):1123–1127.CrossRef
15.
go back to reference Soehnlein O, Zernecke A, Eriksson EE, et al. Neutrophil secretion products pave the way for inflammatory monocytes. Blood. 2008;112(4):1461–1471.CrossRef Soehnlein O, Zernecke A, Eriksson EE, et al. Neutrophil secretion products pave the way for inflammatory monocytes. Blood. 2008;112(4):1461–1471.CrossRef
16.
go back to reference Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet. 2015;386(9988):85–96.CrossRef Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet. 2015;386(9988):85–96.CrossRef
17.
go back to reference Garg PK, Singh VP. Organ failure due to systemic injury in acute pancreatitis. Gastroenterology. 2019;156(7):2008–2023.CrossRef Garg PK, Singh VP. Organ failure due to systemic injury in acute pancreatitis. Gastroenterology. 2019;156(7):2008–2023.CrossRef
18.
go back to reference Fisher J, Linder A. Heparin-binding protein: a key player in the pathophysiology of organ dysfunction in sepsis. J Intern Med. 2017;281(6):562–574.CrossRef Fisher J, Linder A. Heparin-binding protein: a key player in the pathophysiology of organ dysfunction in sepsis. J Intern Med. 2017;281(6):562–574.CrossRef
19.
go back to reference Tyden J, Herwald H, Sjoberg F, Johansson J. Increased plasma levels of heparin-binding protein on admission to intensive care are associated with respiratory and circulatory failure. PLoS One. 2016;11(3):e0152035.CrossRef Tyden J, Herwald H, Sjoberg F, Johansson J. Increased plasma levels of heparin-binding protein on admission to intensive care are associated with respiratory and circulatory failure. PLoS One. 2016;11(3):e0152035.CrossRef
20.
go back to reference Bhatia M. Acute pancreatitis as a model of SIRS. Front Biosci (Landmark Ed). 2009;14:2042–2050.CrossRef Bhatia M. Acute pancreatitis as a model of SIRS. Front Biosci (Landmark Ed). 2009;14:2042–2050.CrossRef
21.
go back to reference Heinzelmann M, Mercer-Jones MA, Flodgaard H, Miller FN. Heparin-binding protein (CAP37) is internalized in monocytes and increases LPS-induced monocyte activation. J Immunol. 1998;160(11):5530–5536.PubMed Heinzelmann M, Mercer-Jones MA, Flodgaard H, Miller FN. Heparin-binding protein (CAP37) is internalized in monocytes and increases LPS-induced monocyte activation. J Immunol. 1998;160(11):5530–5536.PubMed
22.
go back to reference Fisher J, Russell JA, Bentzer P, et al. Heparin-binding protein (HBP): a causative marker and potential target for heparin treatment of human sepsis-induced acute kidney injury. Shock. 2017;48(3):313–320.CrossRef Fisher J, Russell JA, Bentzer P, et al. Heparin-binding protein (HBP): a causative marker and potential target for heparin treatment of human sepsis-induced acute kidney injury. Shock. 2017;48(3):313–320.CrossRef
23.
go back to reference Nunes QM, Mournetas V, Lane B, et al. The heparin-binding protein interactome in pancreatic diseases. Pancreatology. 2013;13(6):598–604.CrossRef Nunes QM, Mournetas V, Lane B, et al. The heparin-binding protein interactome in pancreatic diseases. Pancreatology. 2013;13(6):598–604.CrossRef
24.
go back to reference Linder A, Akesson P, Inghammar M, et al. Elevated plasma levels of heparin-binding protein in intensive care unit patients with severe sepsis and septic shock. Crit Care. 2012;16(3):R90.CrossRef Linder A, Akesson P, Inghammar M, et al. Elevated plasma levels of heparin-binding protein in intensive care unit patients with severe sepsis and septic shock. Crit Care. 2012;16(3):R90.CrossRef
25.
go back to reference Lin Q, Shen J, Shen L, et al. Increased plasma levels of heparin-binding protein in patients with acute respiratory distress syndrome. Crit Care. 2013;17(4):R155.CrossRef Lin Q, Shen J, Shen L, et al. Increased plasma levels of heparin-binding protein in patients with acute respiratory distress syndrome. Crit Care. 2013;17(4):R155.CrossRef
26.
go back to reference Tyden J, Herwald H, Hultin M, et al. Heparin-binding protein as a biomarker of acute kidney injury in critical illness. Acta Anaesthesiol Scand. 2017;61(7):797–803.CrossRef Tyden J, Herwald H, Hultin M, et al. Heparin-binding protein as a biomarker of acute kidney injury in critical illness. Acta Anaesthesiol Scand. 2017;61(7):797–803.CrossRef
27.
go back to reference Tverring J, Vaara ST, Fisher J, et al. Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury. Ann Intensive Care. 2017;7(1):105.CrossRef Tverring J, Vaara ST, Fisher J, et al. Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury. Ann Intensive Care. 2017;7(1):105.CrossRef
28.
go back to reference Juhas S, Harris N, Il’Kova G, et al. RX-207, a small molecule inhibitor of protein interaction with glycosaminoglycans (SMIGs), reduces experimentally induced inflammation and increases survival rate in cecal ligation and puncture (CLP)-induced sepsis. Inflammation. 2018;41(1):307–314.CrossRef Juhas S, Harris N, Il’Kova G, et al. RX-207, a small molecule inhibitor of protein interaction with glycosaminoglycans (SMIGs), reduces experimentally induced inflammation and increases survival rate in cecal ligation and puncture (CLP)-induced sepsis. Inflammation. 2018;41(1):307–314.CrossRef
29.
go back to reference Nunes QM, Su D, Brownridge PJ, et al. The heparin-binding proteome in normal pancreas and murine experimental acute pancreatitis. PLoS One. 2019;14(6):e0217633.CrossRef Nunes QM, Su D, Brownridge PJ, et al. The heparin-binding proteome in normal pancreas and murine experimental acute pancreatitis. PLoS One. 2019;14(6):e0217633.CrossRef
Metadata
Title
Heparin-Binding Protein Levels at Admission and Within 24 h Are Associated with Persistent Organ Failure in Acute Pancreatitis
Authors
Wenqing Shu
Jianhua Wan
Xiaoyu Yang
Jie Chen
Qinyu Yang
Fen Liu
Liang Xia
Publication date
01-10-2021
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 10/2021
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-020-06660-1

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