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Elevated Midkine Serum Levels Are Associated with Long-Term Survival in Critically Ill Patients
Philipp Hohlstein1, Samira Abu Jhaisha1, Eray Yagmur2
1Department for Gastroenterology, Metabolic Disorders and Intensive Care Medicine, RWTH-University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Abstract:
Midkine (Mdk) is a multifunctional protein involved in inflammatory processes. Hence, circulating Mdk is increased in sepsis and has been previously suggested as a potential biomarker in these patients. The aim of this study was to elucidate the role of Mdk serum concentrations in critical illness and sepsis and to verify its value as a prognostic biomarker. Thus, we analyzed the Mdk serum concentrations of 192 critically ill patients on admission to the medical intensive care unit (ICU). While the serum levels of Mdk at admission were similar in septic and nonseptic critical illness (362 vs. 337 ng/L, p = 0.727), we found several interesting correlations of Mdk to laboratory and clinical markers associated with ischemia or hypoxia, e.g., to renal failure and hepatic injury. Mdk serum concentrations at admission did not differ between various causes of sepsis or other critical illness. Most noticeable, we observed upregulated Mdk serum concentrations at admission in patients surviving in the long-term, which was only seen in nonseptic critical illness but not in sepsis. Our study suggests a relevant role of Mdk in critically ill patients in general and highlights the possible protective features of Mdk in critical illness.
Insights
Midkine (Mdk) shows potential as a biomarker in critical illness. Higher Mdk levels in nonseptic patients correlated with long-term survival, suggesting protective roles in critical care.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Immunology
Background:
- Midkine (Mdk) is a protein implicated in inflammatory responses.
- Elevated Mdk levels are observed in sepsis, suggesting its potential as a biomarker.
- The prognostic value of Mdk in critical illness requires further elucidation.
Purpose of the Study:
- To investigate the role of serum Midkine (Mdk) concentrations in critically ill patients.
- To assess Mdk's utility as a prognostic biomarker in sepsis and critical illness.
- To explore correlations between Mdk levels and clinical/laboratory markers of organ dysfunction.
Main Methods:
- Serum Mdk concentrations were analyzed in 192 critically ill patients upon ICU admission.
- Mdk levels were compared between septic and nonseptic critical illness groups.
- Correlations between Mdk levels and markers of ischemia, hypoxia, renal failure, and hepatic injury were examined.
Main Results:
- Serum Mdk levels at admission were comparable between septic and nonseptic critical illness.
- Mdk concentrations showed correlations with markers of renal and hepatic injury.
- Upregulated Mdk levels at admission were associated with long-term survival in nonseptic critical illness, but not in sepsis.
Conclusions:
- Midkine (Mdk) plays a role in critically ill patients.
- Mdk may possess protective functions in critical illness, particularly in nonseptic cases.
- Further research is warranted to fully understand Mdk's prognostic and therapeutic potential in critical care settings.
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