Global Research Landscape and Emerging Frontiers of Heparin-Binding Protein in Sepsis and Infection: A Bibliometric Mapping Study

Heparin-binding protein (HBP), also known as azurocidin, is a neutrophil-derived mediator that modulates vascular permeability and inflammatory responses and has been actively studied in relation to infection and sepsis. Despite significant growth in research on HBP over the last few decades, there has been a lack of an overall picture of research trends worldwide, collaboration networks, and the evolution of themes. This paper aims to trace the knowledge base and evolution of HBP-related research on infection and sepsis using bibliometric methods. The articles were obtained from the Web of Science Core Collection and the Scopus database, which cover publications from 1981 to 2025. Following duplication and screening, 1,599 publications with full bibliographic information were included. Collaboration networks, patterns of keyword co-occurrence, and research hotspots were analyzed using CiteSpace and VOSviewer, whereas descriptive statistics were conducted in Microsoft Excel. The publications and citations alluding to HBP continued to grow, especially since 2010. Sweden, the United States, and the People's Republic of China were the most contributing countries, and the networks of international collaboration focused on Swedish research groups. The most fruitful institutions were Lund University and Karolinska Institutet. Keyword co-occurrence and burst analysis revealed a transition from early molecular/mechanistic research to more clinically focused research, especially those investigating the diagnostic and prognostic capabilities of HBP in organ dysfunction and sepsis. The core journals were primarily in the areas of immunology, critical care, and infectious disease. Overall, HBP research has progressed from molecular discovery toward clinically oriented biomarker evaluation, although large-scale clinical implementation remains limited. Nevertheless, to date, HBP has not been part of standard clinical practice for diagnosing or treating sepsis. Recent research focuses on biomarker validation and prognostic evaluation, arguing that, before any wide-scale clinical use, a biomarker must undergo large-scale validation.