The growth factor/ cytokine midkine may participate to cytokine storm
and contribute to the pathogenesis of SARS-CoV-2 infected patients
Abstract
The current coronavirus disease 2019 (COVID-19) outbreak caused by
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged
in Wuhan, China and has rapidly become global challenges, creating major
challenges to health systems in almost every country in the world it has
turned into a pandemic. COVID-19 poses a risky clinical situation that
can range from mild illness to severe respiratory failure requiring
admission to intensive care. It is known to cause cytokine storm in some
critically ill patients. However, more and more evidence showed that
there is a dramatic increase in cytokine levels in patients diagnosed
with COVID-19. Midkine (MK) is involved in various physiological and
pathological processes, which some of them are desired and beneficial
such as controlling tissue repair and antimicrobial effects, but some
others are harmful such as promoting inflammation, carcinogenesis and
chemo-resistance. Also, MK is expressed in inflammatory cells and
released by endothelial cells under hypoxic conditions. Considering all
this information, there are strong data that MK, an important cytokine
known to increase in inflammatory diseases, may overexpressed in
patients who are positive for COVID-19. The overexpression of MK reveals
a picture leading to fibrosis in the lung damage. Therefore, questions
arise about how the concentration of MK changes in CoVID-19 patients and
can we use it as an inflammation biomarker or in the treatment protocol
in the future.