Elevated MIF-2 levels predict mortality in critically ill patients

J Crit Care. 2017 Aug:40:52-57. doi: 10.1016/j.jcrc.2017.03.012. Epub 2017 Mar 16.

Abstract

Purpose: D-dopachrome tautomerase (MIF-2 or DDT) is a member of the macrophage migration inhibitory factor (MIF) superfamily and a close structural homolog to MIF. Circulating MIF-2 has been described to be elevated in patients suffering from sepsis, severe burn injury and after surgery. We sought to evaluate the prognostic value of MIF-2 in critically ill patients.

Methods: A total of 72 patients were studied upon admission to the medical intensive care unit (ICU). MIF and MIF-2 levels were assessed and compared to healthy controls. Clinical data, various laboratory parameters and mortality were assessed.

Results: We found significantly elevated levels of MIF-2 and MIF at admission to the ICU in critically ill patients compared to healthy controls. MIF-2 levels were associated with disease severity as measured by APACHE II scores. MIF-2 levels in ICU patients correlated with biomarkers reflecting organ damage, but were not influenced by acute or chronic kidney disease. Kaplan-Meier analysis revealed distinctly elevated mortality in patients with high plasma MIF-2 levels.

Conclusions: MIF-2 levels are elevated in critically ill patients and linked to parameters of organ damage, supporting its value as a potential tool for the assessment of prognosis in critical illness.

Keywords: ICU; MIF-2; Organ failure; Prognosis; Sepsis.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • Burns / blood
  • Burns / mortality*
  • Case-Control Studies
  • Critical Illness
  • Female
  • Humans
  • Intensive Care Units
  • Intramolecular Oxidoreductases / blood*
  • Kaplan-Meier Estimate
  • Macrophage Migration-Inhibitory Factors / blood*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Sepsis / blood
  • Sepsis / mortality*

Substances

  • Biomarkers
  • Macrophage Migration-Inhibitory Factors
  • Intramolecular Oxidoreductases
  • MIF protein, human