Growth Factor Midkine Aggravates Pulmonary Arterial Hypertension via Surface Nucleolin

Daisuke Kinoshita, Tetsuro Shishido, Tetsuya Takahashi, Miyuki Yokoyama, Takayuki Sugai, Ken Watanabe, Harutoshi Tamura, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Takuya Miyamoto, Tetsu Watanabe, Satoshi Kishida, Kenji Kadomatsu, Jun ichi Abe, Yasuchika Takeishi, Tsuneo Konta, Isao Kubota, Masafumi Watanabe

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1 Scopus citations


Pulmonary arterial hypertension (PAH) is a progressive fatal disease caused by pulmonary arterial remodeling. Midkine regulates cell proliferation and migration, and it is induced by hypoxia, but its roles in pulmonary arterial remodeling remain unclear. Serum midkine levels were significantly increased in PAH patients compared with control patients. Midkine expression was increased in lungs and sera of hypoxia-induced PAH mice. Hypoxia-induced pulmonary arterial remodeling and right ventricular hypertrophy were attenuated in midkine-knockout mice. Midkine-induced proliferation and migration of pulmonary arterial smooth muscle cells (PASMC) and epidermal growth factor receptor (EGFR) signaling were significantly increased under hypoxia, which also induced cell-surface translocation of nucleolin. Nucleolin siRNA treatment suppressed midkine-induced EGFR activation in vitro, and nucleolin inhibitor AS1411 suppressed proliferation and migration of PASMC induced by midkine. Furthermore, AS1411 significantly prevented the development of PAH in Sugen hypoxia rat model. Midkine plays a crucial role in PAH development through interaction with surface nucleolin. These data define a role for midkine in PAH development and suggest midkine-nucleolin-EGFR axis as a novel therapeutic target for PAH.

Original languageEnglish (US)
Article number10345
JournalScientific reports
Issue number1
StatePublished - Dec 1 2020

ASJC Scopus subject areas

  • General


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