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Circulating midkine in children with Henoch-Schönlein purpura: Clinical implications
Zhantao Su1, Xin Lv2, Yi Liu2
1Pediatric Research Institute, Qilu Children's Hospital of Shandong University, Ji'nan 250022, China; Department of Pediatric, Shandong Police Hospital, Ji'nan 250002, China.
Background:
Midkine (MK) is a heparin-binding growth factor, which behaves like a cytokine, involved in various cellular processes such as cellular proliferation, differentiation, survival, adhesion, and migration. Studies provided evidence for a role of MK in acute and chronic inflammatory processes. The association between midkine and Henoch-Schönlein purpura (HSP) has not yet been explored. The aim of our study was to investigate the potential role of midkine in children with HSP.
Methods:
A total of 152 cases consisting of 92 children with HSP and 60 age- and sex-matched healthy control children were enrolled in this prospective study. Circulating midkine, IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, and IL-17A was measured in all of the 92 patients and 60 healthy controls. Midkine diagnostic value was evaluated by receiver operating characteristic (ROC) analysis.
Results:
Renal involvement occurred in 36 of the 92 patients. Circulating midkine level was elevated in children with HSPN than those of patients without renal involvement and of the controls (326.58 (266.58-459.25) pg/ml versus 280.72 (233.67-384.36) pg/ml and 217.3 (198.98-243.65) pg/ml, respectively; P<0.05). Midkine positively correlated with IL-4, IL-6, IL17A, IgA and IgE. The threshold MK concentration of HSPN was 295.58pg/ml, with the sensitivity and specificity of 80.6% and 88.3%, respectively. The area under the receiver operating characteristic (ROC) curve (AUCROC) of MK was 0.902.
Conclusions:
MK seems to be involved in the development of HSP. Measurement of serum levels of MK is helpful in confirming the diagnosis of HSP and predicting HSPN.
Insights
Midkine (MK) levels are elevated in children with Henoch-Schönlein purpura (HSP), particularly those with kidney involvement (HSPN). MK measurement aids in diagnosing HSP and predicting HSPN.
Area of Science:
- Pediatric immunology
- Cytokine research
- Nephrology
Background:
- Midkine (MK) is a growth factor and cytokine implicated in inflammatory processes.
- The role of MK in Henoch-Schönlein purpura (HSP) has not been previously investigated.
Purpose of the Study:
- To explore the potential involvement of midkine in pediatric Henoch-Schönlein purpura.
- To assess midkine as a diagnostic marker for HSP and its renal complication (HSPN).
Main Methods:
- Prospective study of 92 children with HSP and 60 healthy controls.
- Measurement of serum midkine and various cytokines (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ, IL-17A).
- Receiver operating characteristic (ROC) analysis to evaluate diagnostic value.
Main Results:
- Elevated midkine levels were observed in children with HSP compared to controls.
- Midkine levels were significantly higher in children with HSP and renal involvement (HSPN).
- Midkine positively correlated with IL-4, IL-6, IL17A, IgA, and IgE; ROC analysis showed high diagnostic accuracy for HSPN (AUC=0.902).
Conclusions:
- Midkine plays a role in the pathogenesis of Henoch-Schönlein purpura.
- Serum midkine levels are valuable for diagnosing HSP and predicting renal involvement (HSPN).
