Midkine: Utility as a Predictor of Early Diabetic Nephropathy in Children with Type 1 Diabetes Mellitus

Objective

This study aimed to assess the role of serum midkine (MK) as a biomarker for early detection of diabetic nephropathy in children with type 1 diabetes mellitus (T1DM) before microalbuminuria emerges.

Methods

A total of 120 children with T1DM, comprising 60 microalbuminuric patients (Group 1), 60 normoalbuminuric patients (Group 2), and 60 healthy participants as a control group (Group 3) were included. Detailed medical history, clinical examination, and laboratory assessment of high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c percentage (HbA1c%), lipid profile, urinary albumin to creatinine ratio (ACR), serum MK and estimated glomerular filtration rate based on serum creatinine were performed in all participants.

Results

Both Group 1 and Group 2 had significantly higher serum MK compared to controls (p<0.001). Additionally, significantly higher MK concentrations were present in Group 1 compared with Group 2 (p<0.001). Receiver operating characteristic curve analysis revealed that the MK concentration cutoff value of 1512 pg/mL was able to predict microalbuminuria with a sensitivity of 96% and specificity of 92%. Stepwise regression analysis revealed that HbA1c%, hs-CRP, and ACR were independently related to MK levels (p<0.001 for each).

Conclusion

The results of this study suggest that serum MK is a useful, novel, practical marker for the evaluation of renal involvement in children with T1DM, especially in normoalbuminuric children.

Enhanced efficacy of praziquantel treatment in mice vaccinated with radiation attenuated cercariae of Schistosoma mansoni

Normal, and vaccinated mice four weeks previously with radiation attenuated cercariae of S. mansoni (500/mouse) were challenged with normal cercariae (150/mouse), then treated one week later with praziquantel (400 mg/kg body weight, orally). Worm burden was determined to calculate the % immunity in all groups under study. Histopathological examination of liver, small and large intestine, spleen and lung was done. Serum IgE level was estimated using the immunoradiometric assay. (IRMA). The % immunity was highest among vaccinated, infected and treated group with minimal pathological changes recorded and highest IgE level. From the data collected, it was found that, the efficacy of praziquantel treatment was enhanced in vaccinated mice and that there was synergistic effect between drug treatment and vaccination when praziquantel was given seven days post-infection (challenge).

Effect of praziquantel on sex hormone levels in murine schistosomiasis mansoni

Changes in sex hormonal levels were studied in Schistosoma mansoni infected and praziquantel treated mice (400 x 2 mg/Kg), drug control and in normal control groups. It was observed that schistosomiasis lead to increase in the level of testosterone, progesterone and 17B-esteradiol, 60 and 70 days postinfection in male and female mice, respectively. In praziquantel treated group the level of testosterone was lowered 10, 20 & 30 days post treatment, progesterone and 17 beta-estradiol fell 30 days post treatment after primary rise. The mechanism of recorded changes will be discussed in details.