Infectious diseases remain a major health problem, where
sepsis and other severe
infectious diseases are common causes of morbidity and mortality. The importance of early and appropriate treatment of
sepsis and severe
bacterial infections has been underlined by the successes of measures like the Surviving
Sepsis Campaign, among others. Thus, there is a need for clinical and laboratory tools to identify a patient with severe
infection early and to distinguish between bacterial and non-bacterial conditions.
Heparin-binding protein (HBP) is also called
azurocidin, or cationic antimicrobial
protein of 37 kDa (
CAP37). It is a multifunctional granule-associated
protein that is rapidly mobilized from migrating polymorphonuclear leukocytes. HBP acts as a
chemoattractant, an activator of monocytes and macrophages, and induces vascular leakage and
edema formation. The release of HBP is triggered by
ligation of neutrophilic beta(2)-integrins, a process that may be initiated by bacterial structures. The overall outcome is powerful vascular leakage. It has been shown that patients with
severe sepsis express high levels of HBP in plasma before they develop
hypotension. HBP is also involved in the pathophysiology of
soft tissue infection. In conclusion, this
protein is strongly involved in the pathophysiology of severe
bacterial infections, and thus represents a potential diagnostic marker and a target for treatment.