Prognostic Value of Histidine-Rich Glycoprotein for Community-Acquired Pneumonia.

Xinwei He,Lili Zhao,Qiongzhen Luo,Ying Shang,Zhancheng Gao,Michael Hawkes

doi:10.1155/2022/4713045

Abstract

Purpose Histidine-rich glycoprotein (HRG) is abundant in serum and has been implicated in several processes including blood coagulation and immune response. This prospective study is aimed at exploring HRG as a biomarker in patients hospitalized for community-acquired pneumonia (CAP). Methods A total of 160 patients (73 severe CAP, 57 nonsevere CAP), and 30 healthy controls were enrolled in 2019. Demographic and clinical data were recorded for all patients. Serum HRG concentration was measured upon admission using ELISA. Results HRG levels were significantly lower in severe CAP patients compared with other groups, regardless of etiology, and were negatively correlated with serum interleukin-6 and disease severity index scores. Combination of CURB-65, PSI, and APACHE II scores with HRG values significantly improved the accuracy of predicting 30-day mortality in these patients. Cox regression analysis showed that HRG could serve as an independent risk factor for 30-day mortality. Notably, patients with HRG ≤ 16.92 μg/mL had significantly lower cumulative survival than those with HRG > 16.92 μg/mL. Conclusion Serum HRG levels are lower in patients with severe CAP and are negatively correlated with disease severity scores. Measurement of HRG upon admission can provide valuable prognostic information for patients with CAP.

Highlights

Community-acquired pneumonia (CAP) poses a major threat to public health as a high morbidity and high mortality infectious disease [1]
Recent studies have reported that histidine-rich glycoprotein (HRG), called histidine-proline-rich glycoprotein, levels are lower in cases of systemic inflammatory response syndrome (SIRS) [4] or among patients with ventilator-associated pneumonia (VAP) [5], and that these levels were significantly correlated with prognosis
Categorization of CAP patients based on high (>16.92 μg/mL) or low serum Histidine-rich glycoprotein (HRG) (≤16.92 μg/mL) and subsequent analysis by Cox survival curves revealed that the low HRG group displayed significantly greater mortality rates than that of the high HRG group (p < 0:001, Figure 4), which was independent of other clinical parameters

Summary

Introduction

Community-acquired pneumonia (CAP) poses a major threat to public health as a high morbidity and high mortality infectious disease [1]. Recent studies have reported that histidine-rich glycoprotein (HRG), called histidine-proline-rich glycoprotein, levels are lower in cases of systemic inflammatory response syndrome (SIRS) [4] or among patients with ventilator-associated pneumonia (VAP) [5], and that these levels were significantly correlated with prognosis. These results indicate that HRG may be a promising candidate biomarker for CAP infection. In this work, we prospectively evaluated HRG levels in a cohort of patients with CAP to clarify whether patients with different severities of CAP exhibited differences in HRG levels, indicating potential clinical significance

Materials and Methods

Results

Discussion

Conflicts of Interest