[Show abstract][Hide abstract] ABSTRACT: Targeting Nampt/PBEF/visfatin is considered a promising anticancer strategy, yet little is known about its association with colorectal cancer (CRC). We quantified Nampt/PBEF/visfatin expression in bowel and blood (mRNA and protein), referring it to CRC advancement and inflammatory, angiogenic, hypoxia, and proliferation indices.
Tumor Nampt/PBEF/visfatin upregulation was associated with metastasis, anemia, tumor location, HIF1α, and inflammatory and angiogenic indices, of which HIF1α, IL1β, and anemia explained 70% in Nampt/PBEF/visfatin variability. Nampt/PBEF/visfatin expression in nontumor tissue, both mRNA and protein, increased in patients with metastatic disease and mild anemia, and, on transcriptional level, correlated with HIF1α, IL1β, IL8, CCL2, and CCL4 expression. Whole blood Nampt/PBEF/visfatin tended to be elevated in patients with metastatic cancer or anemia and correlated with inflammatory indices, of which IL1β, IL8, and hematocrit explained 60% of its variability. Circulating visfatin was associated with lymph node metastasis and inflammatory and angiogenic indices. In vitro experiments on SW620 cells demonstrated Nampt/PBEF/visfatin downregulation in response to serum withdrawal but its upregulation in response to serum induction and hypoxia. Stimulation with recombinant visfatin did not provide growth advantage. Summarizing, our results link Nampt/PBEF/visfatin with tumor metastatic potential and point at inflammation and hypoxia as key inducers of its upregulation in CRC.
[Show abstract][Hide abstract] ABSTRACT: Matrix metalloproteinase- (MMP-) 9 is one of the main metalloproteinases reported to be involved in extracellular matrix degradation and recently also in triggering of angiogenic switch in the course of inflammatory bowel diseases (IBD). The goal of our studies was to estimate in one experimental setting the levels of MMP-9 in sera of Crohn's Disease (CD) and ulcerative colitis (UC) patients and to evaluate its possible diagnostic potential in comparison with other biochemical markers and selected proinflammatory and angiogenic factors. The study group included 176 subjects (CD = 64, UC = 85, control = 27). Concentrations of serum MMP-9 were significantly higher in active than inactive forms of IBD, being higher in active UC than in active CD. Both in the case of CD and UC serum MMP-9 positively correlated with disease activity, IL-6 levels, platelet and leukocyte count, midkine, and PDGF-BB, as well as in UC with ESR and in CD with CRP, IL-1, and VEGF-A. Diagnostic accuracy of MMP-9 in distinguishing active UC from active CD was 66%, and displayed higher specificity than CRP (79.0% versus 61.6%, resp.). Evaluation of serum MMP-9 concentrations could aid in differentiation of active UC from active CD. MMP-9 correlated better with inflammatory and angiogenic parameters in CD than in UC.
[Show abstract][Hide abstract] ABSTRACT: Midkine is a multifunctional cytokine found to be a promising cancer biomarker, however, its suitability in colorectal cancer (CRC) has not been evaluated yet. We assessed midkine circulating levels immunoenzymatically in 105 CRC patients, 86 individuals with increased risk for CRC (56 with inflammatory bowel disease (IBD) and 30 with adenomas), and 70 healthy controls and compared its performance as CRC biomarker to carcinoembryonic antigen (CEA). Midkine was higher in CRC (807ng/L) than in IBD (477ng/L; 633ng/L in active and 335ng/L in inactive), adenomas (418ng/L) or controls (245ng/L). Its levels increased along with advancing CRC stage, being significantly higher compared to controls already in stage I, and dedifferentiation (higher in grade 3 than 1 and 2). Lymph node or distant metastases were associated with significant midkine elevation as well. Midkine positively correlated with IL-1β, IL-6, IL-8, TNF-α, MCP-1, MIP-1α, G-CSF, GM-CSF, VEGF-A, and PDGF-BB with IL-1β and PDGF-BB explaining 40% in its variability. Midkine was better marker of CRC than CEA with 80% accuracy, 83% sensitivity and 68% specificity as compared to 60%, 37%, and 88% of CEA, also in its early stages (74% vs. 52% accuracy). Midkine better differentiated CRC from inactive while CEA from active IBD. Midkine was included in the multimarker panel and significantly contributed to efficient (Λ=0.16) differentiation of healthy controls, adenomas and CRC. Concluding, midkine may lack sufficient specificity to be a sole CRC marker but seems to constitute a valuable addition to multimarker panels devised for CRC screening and/or surveillance.
[Show abstract][Hide abstract] ABSTRACT: The etiopathogenesis of inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is still not fully elucidated and seems to be multifactorial. It has been suggested that genetic, immunological and environmental factors participate in IBD development. IBD extraintestinal manifestations include rheumatic, metabolic, dermatologic, ophthalmologic, hepatobiliary, pancreatic, urologic, pulmonary, neurological, hematological and thromboembolic complications. Thyroid gland diseases have not been confirmed as extraintestinal manifestations of IBD. However, it is known that some thyroid diseases share an immunological background with IBD, and that dysfunction of the thyroid gland may induce gastrointestinal symptoms. Ultrasound examination is the gold standard for evaluation of thyroid gland morphology.
This study was designed to assess the prevalence of abnormalities in the structure of the thyroid gland in IBD patients and to compare it to the control group.
The study group consisted of 199 consecutive IBD patients (80 CD patients and 119 UC patients) hospitalized at the Department of Gastroenterology and Hepatology of Wroclaw Medical University (Poland). The control group consisted of 42 healthy volunteers and patients with functional gastrointestinal disorders.
The most common finding in the ultrasound examination in IBD patients were tumors. Tumors, which were smaller than or equal to 10 mm were present in 11.5% of IBD patients; and tumors larger than 10 mm were present in 13.1%. These results show that small tumors (less than 10 mm in diameter) of the thyroid gland are more frequent among patients with CD and UC compared to the control group (p = 0.0001 and p = 0.001, respectively). Additionally, enlargement of the thyroid gland occurs more often in UC patients compared to the control group (p = 0.003). There was no difference in the frequency of thyroid abnormalities between UC and CD patients.
In patients with inflammatory bowel diseases focal lesions relating to tumors of the thyroid gland are more common than in the control group. In patients with ulcerative colitis enlargement of the thyroid gland is more frequent than in the control group. Initial assessments of IBD patients should include ultrasound examinations of the thyroid gland.
Preview · Article · Dec 2012 · Advances in Clinical and Experimental Medicine
[Show abstract][Hide abstract] ABSTRACT: Crohn's disease (CD) is an incurable and difficult to diagnose condition. While high sensitive C-reactive protein (CRP) remains the best biochemical marker, we evaluated the diagnostic usefulness of lipid peroxidation indices.
Malondialdehyde/thiobarbituric acid-reactive substances (MDA/TBARS), peroxidation potential (PP), lipid hydroperoxides (ROOH), oxidized-low density lipoprotein (oxLDL), and oxLDL antibodies (OLAB) were assessed in 52 CD patients and 99 volunteers and referred to clinical activity, inflammation, nutritional and antioxidant status.
MDA/TBARS were higher in CD while oxLDL and PP decreased in active disease and ROOH and OLAB did not differ. oxLDL and PP negatively and OLAB positively correlated with CD activity. MDA/TBARS positively correlated with IL-6 and SOD-1 and negatively with catalase. IL-6 and SOD-1 explained 24% in MDA/TBARS variability. PP negatively correlated with CRP, platelets, and IL-6 and positively with glutathione peroxidase-1, paraoxonase-1, cholesterol, triglycerides, and albumins. Cholesterol and CRP explained 57% in PP variability. oxLDL negatively correlated with IL-1 and IL-6 and positively with glutathione peroxidase-1, paraoxonase-1, cholesterol, and albumins. Paraoxonase-1 explained 17% of oxLDL variability. OLAB positively correlated with IL-1 explaining 10% in its variability and negatively with cholesterol. MDA/TBARS were the best predictor of CD, comparable to CRP, with high specificity (MDA/TBARS sensitivity and specificity: 75% and 90%; CRP: 76% and 93%). Combined assessment of MDA/TBARS and CRP improved sensitivity (94%) corresponding with acceptable specificity (81%).
MDA/TBARS are elevated in CD and may help to rule the disease out, while the combined evaluation with CRP may serve for CD confirmation. oxLDL and PP depended on substrate availability, decreased in CD.
No preview · Article · Oct 2012 · Clinical Chemistry and Laboratory Medicine
[Show abstract][Hide abstract] ABSTRACT: Neurotransmitters might participate in the development of diverticular disease. We measured fasting and postprandial serotonin levels in colonic diverticulosis patients and healthy volunteers. We demonstrated significantly lower maximal concentrations of serotonin in patients than the controls (respectively 109.8±61.4 and 251.3±44.1 ng/ml, p<0.001) as well as lower serotonin minimal values (respectively 38.4±21.8 and 124.6±41.4 ng/ml, p<0.001) and areas under time-course curves (respectively 288.8±139.8 and 739±167.4 ng/ml, p<0.001); significant difference between alternating pattern and normal bowel habit concerning fasting serotonin level, the hormone response to test meal (p=0.041) as well as minimal serotonin level (p=0.044). Bowel habit was also related to peak serotonin values following a test meal with 38.5 ng/ml in constipation, 139.5 ng/ml in diarrhea, 122.4 ng/ml in alternating pattern and 249 ng/ml in subjects with normal bowel habit (p=0.040) as well as AUC with 120.8 ng/ml in constipation, 416 ng/ml in diarrhea, 298 ng/ml in alternating pattern and 684 ng/ml in subjects with normal bowel habit (p=0.043). We demonstrated substantial differences in fasting serum serotonin levels as well as the hormone response to a test meal between colonic diverticulosis patients and healthy individuals, which seemed to be associated with abnormal bowel habits rather than presence of diverticula.
No preview · Article · Oct 2012 · Central European Journal of Medicine
[Show abstract][Hide abstract] ABSTRACT: Introduction: Malnutrition often occurs in patients with inflammatory bowel disease (IBD), especially in the acute phase but also in remission, mostly as a result of improper diet.
The aim of the study was to assess the nutritional status of patients with Crohn’s disease (CD) and ulcerative colitis (CU) in active phase and in remission.
Material and methods: In this study were 64 CD patients (31 women and 33 men) and 111 CU patients (46 women and 65 men). The nutritional status in active disease was assessed using the Mini Nutritional Assessment (MNA), anthropometric measurements, and biochemical tests. The assessment of nutritional status in remission was performed on the basis of 24-hour dietary intake.
Results: The MNA results showed malnutrition in 12.5% of the CD patients and a risk of malnutrition in ca. 50% of the CD and CU patients. The concentrations of iron and total cholesterol in serum as well as blood hemoglobin were below the normal ranges in 53.3, 34.5, and 52.1% of the total patients with IBD, respectively. Patients in remission consumed lower amounts of carbohydrates and polyunsaturated fatty acids compared with dietary recommendations. Inadequate amounts of Ca, Fe, Zn, Cu, thiamin, riboflavin, niacin, and pyridoxine were available in the IBD female diets and inadequate intake of Mg, Zn, and riboflavin was observed in the IBD males.
Full-text · Article · Jan 2011 · Gastroenterologia Polska
[Show abstract][Hide abstract] ABSTRACT: Background. Gastroesophageal reflux disease (GERD) is a disease of modern civilization whose symptoms occur in 5-10% of individuals living in Western countries. Proton pump inhibitors (PPIs) are the basis of the medical treatment of GERD. PPIs are metabolized with the system of enzymes of cytochrome P450. Polymorphism of the isoenzymes comprising this system determines the different speeds of the metabolism of the drugs. Objectives. The aim of the study was the analysis of CYP2C19 polymorphism in GERD patients in relation to the presence of GERD complications. Material and Methods. The study group consisted of 40 patients hospitalized in the Department of Gastroenterology and Hepatology of Wroclaw Medical University with a diagnosis of GERD and 17 patients treated surgically in the Clinic of Gastrointestinal and General Surgery of Wroclaw Medical University due to GERD complications. Two SNP-type polymorphisms in gene CYP2C19 were studied with the PCR-RFLP (polymerase chain reaction, restriction fragment length polymorphism) method. Results. Most of the patients were found to belong to the phenotype of extensive metabolizers (EM). Genotypes and frequency of the alleles of polymorphism 681G-→A in gene CYP2C19 in GERD patient groups with and without complications are shown in table 2. Conclusions. Most of the patients with uncomplicated GERD belong to the phenotype of extensive metabolizers (EM). Our results do not suggest that the polymorphism of gene CYP2C19 plays a role in the development of severe GERD complications.
No preview · Article · Jan 2011 · Advances in Clinical and Experimental Medicine
[Show abstract][Hide abstract] ABSTRACT: The objective of the study was to evaluate whether severe sepsis and septic shock are related to alterations in midkine concentrations, to identify disease-related factors associated with these alterations, and to initially appraise whether midkine might serve as a biomarker in sepsis. Prospective observational cross-sectional study with 5-day follow-up. Circulating midkine was measured (enzyme-linked immunosorbent assay) in 38 septic (13 with severe sepsis, 25 with septic shock), 82 active inflammatory bowel disease (IBD) (26 with systemic inflammatory response syndrome [SIRS]) patients, and 87 healthy subjects. Midkine significantly increased along with a sequence: health-inflammation (IBD)-systemic inflammation (IBD-SIRS)-severe sepsis/septic shock. High midkine levels (>1,000 ng/L) were found in 63% of septic and in 19% of IBD-SIRS patients, whereas extremely high concentrations (>5,000 ng/L) were found in 16% vs. 4%. Although not different at admission, midkine gradually decreased in severe sepsis and remained high in shock. Similarly, persistently high midkine was observed in patients with cardiovascular insufficiency (CVI) and in mechanically ventilated as compared with normalizing levels in patients without CVI and not requiring ventilation. The differences in devised simple rates (Δ5th-1st) were significant in all these cases. Accordingly, admission midkine was higher in patients with metabolic acidosis. Concerning pathogen, gram-positive infections were associated with the highest midkine levels. In conclusion, sepsis and septic shock are associated with midkine elevation, substantially more pronounced than in inflammation, even systemic, revealing a new potential mediator of deregulation of neutrophil migration. Sepsis-related global hypoxia seems to contribute to midkine elevation. Our results substantiate further research on possible midkine application as a sepsis biomarker: in differentiating SIRS from sepsis and identifying gram-positive sepsis and septic patients at risk of CVI and shock.
No preview · Article · Dec 2010 · Shock (Augusta, Ga.)
[Show abstract][Hide abstract] ABSTRACT: Background:Oxidative stress contributes to the propagation and exacerbation of inflammatory bowel disease (IBD) but the status of erythrocyte antioxidant defense remains unknown.Methods:Erythrocyte activities of superoxide dismutase-1 (SOD1), catalase, and glutathione peroxidase-1 (GPx1) were determined in 174 IBD patients and 105 controls and referred to IBD activity, inflammation severity, nutritional status, systemic oxidative stress, anemia, and treatment.Results:Catalase and GPx1 activities were decreased in active IBD, whereas SOD1 became upregulated by IBD-related oxidative stress. In Crohn's disease (CD) corticosteroids decreased SOD1 activity. SOD1 correlated indirectly with CD activity and erythrocyte sedimentation rate (ESR) and directly with transferrin. In ulcerative colitis (UC) anemia downregulated SOD1. Decreases in GPx activity corresponded with IBD activity, anemia, inflammation, and malnutrition. Oxidative stress in UC and corticosteroids in CD also downregulated GPx. Catalase activity was decreased by CD-related anemia, correlating directly with hemoglobin, and indirectly with CD activity, inflammatory and protein oxidative stress markers. When co-analyzed, anemia but not CD activity significantly contributed to catalase downregulation. In UC, catalase activity corresponded indirectly with UC endoscopic activity and inflammation and directly with hemoglobin. UC activity, anemia, and treatment with azathioprine negatively affected catalase. As indicators of active IBD, GPx1 showed a diagnostic accuracy of 73%, whereas catalase showed 63% as compared to 74% of C-reactive protein and ESR.Conclusions:Erythrocyte antioxidant defense is impaired in active IBD. SOD1, GPx1, and CAT activities are differently affected by the disease type, activity, anemia, inflammation, oxidative stress, and treatment. As an active IBD indicator, GPx1 was comparable to C-reactive protein and ESR. Inflamm Bowel Dis 2010
[Show abstract][Hide abstract] ABSTRACT: Background. Colonic diverticulosis is characterized by different prevalence rate in different world regions and an increase in morbidity rates corresponding to the change of lifestyle due to the civilization development. Objectives. This study was aimed to evaluate frequency of diverticulosis in colonoscopic examinations. Additionally, age and gender of patients, location of diverticula, presence of complications of diverticulosis and accompanying diseases were evaluated. Material and Methods. The authors analyzed 3011 colonoscopic reports of patients hospitalized in Department of Gastroenterology and Hepatology, Wroclaw Medical University. Study group encompasses 1776 women at the age of 17-98 (mean age 54.4) and 1235 men at the age of 18-100 (mean age 52.5). Results. Diverticula were found in 425 (14.11%) patients. The most common abnormality were polyps present in 434 of patients. The most frequent location of diverticulosis was sigmoid and descending colon. Disease spreads in continuous way. Patients with diverticulosis were older than patients without diverticulosis. There was no significant difference between mean age and location of diverticula (right-sided versus left-sided; p = 0.328). Frequency of diverticulosis did not differ between men and women. The only one complication detected in colonoscopy was SCAD (segmental colitis associated with diverticulosis). Among accompanying conditions polyps were the most frequent and present in 96 (22.58%) patients with diverticulosis. Conclusions. Diverticulosis is the second most common abnormality of the large intestine in colonoscopy. Diverticula occur the most frequently in sigmoid and descending colon and spread in continuous way. Men and women are affected with the same frequency and prevalence increases with age. The most common accompanying condition are polyps.
No preview · Article · Jul 2010 · Advances in Clinical and Experimental Medicine
[Show abstract][Hide abstract] ABSTRACT: Przeciwciała przeciwko czynnikowi martwicy nowotworów α w terapii podtrzymującej remisję w nieswoistych zapaleniach jelit Abstract Inflammatory bowel disease (IBD) comprises chronic inflammatory conditions of the digestive tract including ulcerative colitis, Crohn's disease, and indeterminate colitis. The etiopathogenesis of IBD remains unknown and is probably multifactorial. A key pro-inflammatory cytokine in IBD is tumor necrosis factor α (TNF-α). The goals of the medical treatment of IBD include inducing a clinical response, maintaining clinical remission, mucosal healing, minimizing the use of corticosteroids, improvement of quality of life, and prevention of colorectal cancer. A huge advance in the therapy of inflammatory bowel disease has been the introduction of biological therapies with anti-TNF-α antibodies (infliximab, adalimumab, certolizumab) already administrated in clinical practice (Adv Clin Exp Med 2010, 19, 2, 143–150).
Preview · Article · Mar 2010 · Advances in Clinical and Experimental Medicine
[Show abstract][Hide abstract] ABSTRACT: A noninvasive marker facilitating differential diagnosis in Crohn's disease (CD) is sought after. Midkine is a heparin-binding growth factor of angiogenic and chemotactic properties, positively evaluated as a tumor marker, and a possible association with CD has not yet been investigated.
Circulating midkine was measured in 91 CD patients and 108 controls and related to disease clinical and biochemical activity, inflammation severity, and angiogenesis. Midkine diagnostic value in comparison with C-reactive protein (CRP) was evaluated by receiver operating characteristic (ROC) analysis.
Circulating midkine was elevated both in quiescent and active disease compared to controls (147, 506, and 93 pg/mL, respectively), and corresponded well with disease activity (r = 0.49, P < 0.001). Midkine significantly correlated with inflammatory indices: CRP (r = 0.49), erythrocyte sedimentation rate (r = 0.31), leukocytes (r = 0.48), platelets (r = 0.52), albumin (r = -0.49), transferrin (r = -0.47), and IL-6 (r = 0.54); hematological variables: hemoglobin (r = -0.38), hematocrit (r = -0.43), and iron (r = -0.58); angiogenic factors: vascular endothelial growth factor-A (r = 0.42), fibroblast growth factor-2 (r = 0.54), and platelet-derived growth factor-BB (r = 0.57). Midkine elevation corresponded well (r = -0.41) with the drop in paraoxonase-1 activity-a quorum-quenching factor. Midkine as a marker of active CD had sensitivity and specificity of 86% and 97%, respectively, whereas CRP was 83% and 92%.
CD is associated with an elevation of midkine, which corresponds well with disease activity and reflects the severity of inflammatory response and exacerbation of pathological angiogenesis. Midkine performance as a disease marker was slightly better than that of CRP. Its high specificity and likelihood ratios for positive test results might recommend midkine as a possible "ruling in" marker in CD.
Full-text · Article · Feb 2010 · Inflammatory Bowel Diseases
[Show abstract][Hide abstract] ABSTRACT: It is currently believed that the pathogenesis of inflammatory bowel disease (IBD) includes genetic, immunological, and environmental factors. Dietetic factors are considered to be among the environmental factors. Results of epidemiological studies suggest that the diet of western countries, poor in fiber and rich in sugar and animal fat, may influence the risk of IBD. However, there are no studies strongly confirming the involvement of dietetic factors in IBD's pathogenesis. Therefore there are no dietetic recommendations to decrease the risk of IBD. The influence of diet on disease course has also not been confirmed. However, malnutrition, anemia, iron deficiency, osteopenia, and osteoporosis are significant clinical problems in IBD patients which require appropriate diagnosis and treatment.
No preview · Article · Jan 2010 · Gastroenterologia Polska
[Show abstract][Hide abstract] ABSTRACT: Maintenance therapy in inflammatory bowel disease (IBD) involves 5′-aminosalicylate derivatives, immunosuppressive drugs (azathioprine, 6-mercaptopurine, methotrexate), and biological agents, which are a breakthrough in the therapy of IBD. Among the biological agents currently available in clinical practice are the anti-tumor necrosis factor α (TNF-α) antibodies infliximab, adalimumab, and certolizumab. The effectiveness of anti-TNF-α antibodies in the maintenance therapy of Crohn's disease was confirmed in clinical trials. The anti-TNF-α agents have different routes of administration, but their effectiveness and safety profiles seem to be similar. Evaluation of the safety of long-term anti-TNF-α therapy requires further studies. This article discusses the rules of maintenance therapy in IBD and describes the special role of biological agents and their place in the guidelines on the management of inflammatory bowel disease.
No preview · Article · Jan 2010 · Gastroenterologia Polska
[Show abstract][Hide abstract] ABSTRACT: The small intestine is an important place of drug metabolism and drug interactions. Intestinal mucosa contains phase-I and phase-II metabolism enzymes and also transport proteins belonging to the family of ATP binding cassette transporters. The importance of small intestine metabolism has been supported by clinical studies in which the intestinal metabolism of some drugs was greater than the hepatic one. Clinical relevance of small intestinal metabolism depends on the enzymes involved, the therapeutic index of the drug, genetic and inherited interindividual variability, general and hormonal state of the patient and concomitant drug or food. The article discusses the role of the small intestine in drug metabolism, including enzymes and transport proteins which are involved in the process.
No preview · Article · Jan 2010 · Gastroenterologia Polska
[Show abstract][Hide abstract] ABSTRACT: First European Crohn's and Colitis Organization (ECCO) consensus regarding definition, diagnosis, management and special situations in Crohn's disease (CD) was published in 2006. At the beginning of 2010 new consensus was published, updated due to the new evidence. The paper discusses the differences between ECCO consensus from 2006 and 2010. A basic examination for establishing the diagnosis of CD is ileocolonoscopy with the biopsies of the terminal ileum and colon. MR and CT enterography or enteroclysis are recommended for small bowel evaluation. Faecal calprotectin and lactoferrin may be used in the initial assessment of patients with the suspicion of CD. Major change regarding the therapy is an increase of the number of indications for anti-TNF treatment. It seems that currently available anti-TNF agents have similar efficacy and safety profile. Thus, the choice of medication depends on the cost, availability, route of delivery, patient's decision and national recommendations.
No preview · Article · Jan 2010 · Gastroenterologia Polska
[Show abstract][Hide abstract] ABSTRACT: Non-invasive biochemical markers are needed to support the diagnosis of ulcerative colitis (UC), an incurable disease of unknown pathology. Midkine is an angiogenic cytokine, chemotactic towards neutrophils and macrophages, and a T-regulatory cell suppressor.
Serum midkine was measured immunoenzymatically in 93 UC patients and 108 healthy subjects, and evaluated with respect to disease status, endoscopic, inflammatory and angiogenic activity. The diagnostic value of midkine was compared to C-reactive protein (CRP) using receiver operating characteristics (ROC) analysis.
Midkine was higher (p<0.0001) in inactive (199 ng/L) and active UC (351 ng/L) compared with controls (93 ng/L), and reflected disease activity (r=0.427, p<0.001). Midkine was correlated with CRP, erythrocyte sedimentation rate (ESR), leukocytes, platelets, interleukin-6, paraoxonase-1, albumin, transferrin, iron, hemoglobin, and hematocrit. Midkine correlated with angiogenic factors: vascular endothelial growth factor-A and platelet-derived growth factor-BB. As a marker of UC, midkine showed a diagnostic accuracy of 85%, sensitivity of 72%, specificity of 82%, whereas CRP showed 83%, 65% and 91%, respectively. As a marker of active UC, midkine showed a diagnostic accuracy of 87%, sensitivity of 84%, specificity of 75%, whereas CRP showed 75%, 63% and 83%, respectively. Combined assessment of midkine and CRP improved sensitivity but substantially decreased specificity.
UC is associated with increased circulating midkine, which corresponds with clinical, endoscopic, inflammatory and angiogenic activity, and anemia. Performance of midkine as a marker of UC or active UC was comparable to that of CRP.
Full-text · Article · Sep 2009 · Clinical Chemistry and Laboratory Medicine