Role of heparin-binding protein, glycocalyx in Sepsis-induced coagulopathy

Abstract Background To explore the role of heparin-binding proteins released from glycocalyx and neutrophils in the mechanism of Sepsis-induced coagulopathy development. The therapeutic mechanism of Heparin in septic coagulation caused by Hparin-binding Protein and glycocalyx was studied by comparing the changes of Hparin-binding Protein and glycocalyx metabolites before and after heparin administration. Methods Patients diagnosed with sepsis from November 2021 to November 2022 were selected and prospectively studied. Basic clinical data were collected and main indicators were detected for enrolled patients. Hparin-binding Protein and glycocalyx metabolites(HA、HS、SDC-1) were determined by ELISA kit. The main observation indexes were the changes of Hparin-binding Protein and glycocalyx metabolites in two groups before and after heparin administration. Results A total of 148 subjects were screened, and 80 met inclusion and exclusion criteria. Of these, 24 were in the SIC( Sepsis-induced coagulopathy) group and 56 were in the non-SIC group. The levels of HBP(Hparin-binding Protein) and glycocalyx metabolites in SIC group were higher than those in non-SIC group. After heparin treatment, the levels of HBP in SIC and non-sic groups were increased, and the levels of glycocalyx metabolites were decreased. Compared with the non-SIC group, patients in the SCI group had more significant increase in HBP level and decrease in glycocalyx metabolites. Conclusion Plasma HBP may affect blood coagulation and endothelial function on glycocalyx. Heparin may indirectly protects the glycocalyx by replacing the HBP that binds to the glycocalyx.