Circulating midkine in Crohn's disease: clinical implications

Area of Science:

• Gastroenterology
• Biomarkers
• Inflammation Research

Background:

• Crohn's disease (CD) lacks a reliable noninvasive diagnostic marker.
• Midkine, a growth factor with angiogenic and chemotactic properties, has not been studied in relation to CD.

Purpose of the Study:

• To investigate circulating midkine levels in CD patients.
• To assess the correlation of midkine with disease activity, inflammation, and angiogenesis.
• To evaluate midkine's diagnostic performance compared to C-reactive protein (CRP).

Main Methods:

• Circulating midkine was measured in 91 CD patients and 108 controls.
• Midkine levels were correlated with clinical and biochemical disease activity, inflammatory indices, hematological variables, and angiogenic factors.
• Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis, comparing midkine to CRP.

Main Results:

• Circulating midkine was significantly elevated in both active and quiescent CD compared to controls.
• Midkine levels strongly correlated with disease activity indices, inflammatory markers (CRP, IL-6), angiogenic factors (VEGF-A, FGF-2, PDGF-BB), and hematological variables.
• Midkine demonstrated high sensitivity (86%) and specificity (97%) for active CD, outperforming CRP (83% sensitivity, 92% specificity).

Conclusions:

• Elevated midkine is associated with Crohn's disease and reflects disease activity, inflammation severity, and pathological angiogenesis.
• Midkine exhibits superior diagnostic performance compared to CRP for active CD.
• Midkine shows potential as a highly specific noninvasive marker for ruling in Crohn's disease.