Woulfe Kathleen C, Sucharov Carmen C
Department of Medicine, University of Colorado Denver, Denver, CO 80045, USA.
J Cardiovasc Dev Dis. 2017 Sep;4(3). doi: 10.3390/jcdd4030013. Epub 2017 Aug 24.
Midkine (MDK) is a heparin-binding growth factor that is normally expressed in mid-gestational development mediating mesenchymal and epithelial interactions. As organisms age, expression of MDK diminishes; however, in adults, MDK expression is associated with acute and chronic pathologic conditions such as myocardial infarction and heart failure (HF). The role of MDK is not clear in cardiovascular disease and currently there is no consensus if it plays a beneficial or detrimental role in HF. The lack of clarity in the literature is exacerbated by differing roles that circulating and myocardial MDK play in signaling pathways in cardiomyocytes (some of which have yet to be elucidated). Of particular interest, serum MDK is elevated in adults with chronic heart failure and higher circulating MDK is associated with worse cardiac function. In addition, pediatric HF patients have higher levels of myocardial MDK. This review focuses on what is known about the effect of exogenous versus myocardial MDK in various cardiac disease models in an effort to better clarify the role of midkine in HF.
中期因子（MDK）是一种肝素结合生长因子，在妊娠中期发育过程中正常表达，介导间充质和上皮的相互作用。随着生物体衰老，MDK的表达会减少；然而，在成年人中，MDK的表达与急性和慢性病理状况相关，如心肌梗死和心力衰竭（HF）。MDK在心血管疾病中的作用尚不清楚，目前对于它在心力衰竭中起有益还是有害作用尚无共识。文献中缺乏明确结论的情况因循环MDK和心肌MDK在心肌细胞信号通路中所起的不同作用（其中一些作用尚未阐明）而更加严重。特别值得关注的是，慢性心力衰竭成人患者的血清MDK升高，且循环MDK水平越高，心脏功能越差。此外，小儿心力衰竭患者的心肌MDK水平更高。本综述重点关注外源性MDK与心肌MDK在各种心脏疾病模型中的作用，以期更好地阐明中期因子在心力衰竭中的作用。
