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Serum Midkine as a Potential Biomarker Associated with Disease Severity and Remodeling-Related Mediators in Children
Yongtian Xu1, Lixia Zhao1, Yingying Mi1
1Department of Pediatrics, Shanghai University of Medicine and Health Science Affiliated Gongli Hospital, Shanghai, People's Republic of China.
Introduction:
Asthma is a heterogeneous inflammatory airway disease in children, for which reliable circulating biomarkers reflecting disease severity and remodeling-associated inflammation remain limited. Midkine, a heparin-binding growth factor involved in inflammatory and fibrotic processes, has emerged as a potential biomarker; however, its clinical relevance in pediatric asthma remains unclear. This study aimed to investigate the association between serum midkine levels and disease severity in children with asthma.
Methods:
We enrolled 109 children with asthma (classified into mild, moderate, and severe groups) and 110 healthy controls. Children with asthma were classified into mild, moderate, and severe groups according to the Global Initiative for Asthma (GINA) criteria, and serum midkine levels were measured by ELISA, along with clinical and lung function assessments.
Results:
Serum midkine levels were significantly higher in children with asthma than in healthy controls and increased progressively with disease severity. Receiver operating characteristic analysis demonstrated good diagnostic performance of serum midkine for asthma (AUC = 0.949), with a sensitivity of 87.2% and specificity of 94.5% at a cutoff value of 948 pg/mL. Additionally, serum midkine levels were negatively correlated with lung function parameters (FEV1, FEV1/FVC, and PEF) and positively correlated with eosinophilia, total immunoglobulin E (IgE), fractional exhaled nitric oxide (FeNO), pro-inflammatory cytokines, and remodeling-related mediators.
Conclusion:
These findings highlight midkine as a promising biomarker and potential therapeutic target for asthma.
Insights
Serum midkine levels are elevated in children with asthma and correlate with disease severity. Midkine shows potential as a biomarker for diagnosing pediatric asthma and assessing inflammation.
Area of Science:
- Pediatric Pulmonology
- Biomarker Discovery
- Inflammatory Diseases
Background:
- Asthma in children is a complex inflammatory airway disease with limited reliable biomarkers for severity and inflammation.
- Midkine, a growth factor, is implicated in inflammation and fibrosis, but its role in pediatric asthma is not well-defined.
Purpose of the Study:
- To investigate the association between serum midkine levels and asthma severity in children.
- To evaluate midkine as a potential diagnostic biomarker for pediatric asthma.
Main Methods:
- 109 children with asthma (mild, moderate, severe) and 110 healthy controls were enrolled.
- Serum midkine levels were measured using ELISA.
- Clinical data, lung function tests, and inflammatory markers were assessed.
Main Results:
- Serum midkine levels were significantly higher in asthmatic children compared to controls and increased with asthma severity.
- Midkine demonstrated high diagnostic accuracy for asthma (AUC=0.949, sensitivity=87.2%, specificity=94.5%).
- Elevated midkine correlated with poorer lung function, eosinophilia, increased IgE, FeNO, and inflammatory mediators.
Conclusions:
- Serum midkine is a promising biomarker for assessing asthma severity and inflammation in children.
- Midkine may serve as a diagnostic tool and a potential therapeutic target for pediatric asthma.
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