Good microcirculation indicates increased lifespan
Hennigsdorf, Germany – 05. September 2016
A study on centenarians links sphingotec’s biomarker bio-Adrenomedullin (bio-ADM) to longevity. Human longevity has been previously linked by researchers to genetic factors, calorie restriction, and certain life-style factors such as physical activity or the Mediterranean diet. Now, Italian researchers from La Sapienza University in Rome have identified an additional factor, which significantly contributes to a longer life. In a pilot study on some of the oldest people of the world, they discovered that the perfusion of organs and muscles of the centenarians was as efficient as that in people who were 30 years younger. Results of the CIAO (Cilento Intitiative on Aging Outcome) pilot study,presented today in the Italian town of Pollica, suggest that low blood levels of the peptide hormone.
Adrenomedullin (bio-ADM) are an indicator for such a good microcirculation. Making longevity measurable has long been a scientific goal as it could open up the avenue to a systematic identification of factors contributing to an extended life span.
Prof. Salvatore Di Somma and his team carried out comprehensive health and life style assessments of two study groups that live in the Cilento region, located in the province of Salerno in southern Italy: In the first were 29 so-called ‘SuperAgers’ (median age 92 years), while the second was made up of 52 younger relatives (median age 60 years, living in the same household) who are expected to live just as long because they have the same genetic background and have been exposed to the same environmental and lifestyle factors. Blood biomarker analyses were carried out by the diagnostic company sphingotec (Hennigsdorf, Germany). It measured levels of the heart-function biomarker MRproANP, as well as a marker for kidney function (penKid) and bio-ADM. The last is a regulator of vasodilation and blood vessel integrity, which both affect blood pressure. The results were compared to those of a cohort of 194 healthy persons (median age 63.9 years), who were monitored over eight years in the earlier Malmö Preventive Project (MPP, Principal Investigator Professor Olle Melander, Lund University, Sweden).
As expected, low values of MR-proANP and penKid among the subjects in the two younger control groups indicated no signs of heart or kidney dysfunction. In contrast, both biomarkers were elevated in the SuperAgers, possibly due to the process of organ aging. However, even though the older group had levels of the two biomarkers that were as high as those found in patients experiencing heart failure (HF) or acute kidney injury (AKI), they were in clinically good condition. Surprisingly, in the group of SuperAgers, the bio-ADM values – which are often pathologically elevated in HF or AKI patients – were as low as those in both reference groups.
“Very low concentrations of this biomarker indicate a well-functioning endothelial and microcirculatory system allowing good blood perfusion of organs and muscles,“ concludes Di Somma. A good microcirculation is what makes marathon runners perform better at the same heart rate than the average man or woman on the street.
“We are excited about the connection between bio-ADM levels and a good microcirculation as an indicator for good quality of life”, says sphingotec founder Andreas Bergmann, who was instrumental in developing the bio-ADM assay. “If bio-ADM proves to be a reliable biomarker for longevity this will open up the avenue to a systematic analysis of the factors contributing to longevity“, he adds. ”We are excited to contribute to the identification of lifestyle factors ensuring a good microcirculation.” The researchers are currently planning to extend the pilot study to 2,000 people from the Cilento region. One major goal of the follow-up study is to investigate whether certain components of the local Mediterranean diet could affect the bio-ADM level. The cuisine typical to the region traditionally uses number of plants native to the area. Another idea is to bring people with high bio-ADM levels to Cilento and measure whether the local environment has an effect on levels of the microcirculation biomarker.
The CIAO (Cilento Intitiative on Aging Outcome)
study was designed to identify life style, genetic and epigenetic factors contributing to longevity in the Cilento region. With an average life expectancy of 92 years for women (Italian average: 84) and 85 years for men (Italian average: 79), the Cilento has one of the world’s highest concentrations of centenarians – even higher than in Okinawa (Japan), the most intensively investigated centenarian hotspot. The contributors to the current pilot study were identified through local physicians who acquired the informed consent of their patients. A mobile bus equipped with all instrumentation for a comprehensive health assessment was used to visit the study participants. Additionally, blood samples for biomarker analysis were taken and participants were interviewed about their life style habits.
Microcirculation
describes blood flow through the smallest vessels (capillaries) in the circulatory system. In these regions, oxygen and nutrients are directly delivered to cells, while metabolic debris, toxins and CO2 are winnowed out. Blood pressure and body temperature is also controlled by the microcirculation through dilation or constriction of the capillary network that penetrates muscles, organs and skin. If put end-to-end, the body’s capillaries would stretch 90,000-110,000 kilometers – more than twice the circumference of Earth. If placed side-by-side, they would cover an area the size of two football fields (500-700 sqm). On average, people have around 200-300 capillaries/mm2, but endurance athletes like runners can have up to 40% more (300-500 capillaries/mm2). This contributes to better muscle perfusion, oxygen supply and performance.
Salvatore Di Somma (63),
Professor of Internal Medicine at the University La Sapienza in Rome, is the organizer of the CIAO pilot study. Strong personal links have given him unique access to the population of centenarians living in the Cilento. In previous studies, he identified rosemary as an ethnobotanically conserved part of the local Mediterranean cuisine that might could be contributing to longevity in the region. Conserved gene variants associated with longevity were also identified in Cilento’s population in the Southern Italy Centenarian Study (SICS). The variants affect insulin sensitivity (FOXOA3, CAMMIV), RNA editing (ADARB1+2) and the aromatase pathway (Cyp19,ESR1). Additionally, a unique profile of lipids in the membrane of red blood cells (erythrocytes) was identified in 2008 within the the framework of the SICS study
Centenarian hotspots:
Several regions have been identified by National Geographic writer Dan Buettner as longevity hotspots. They include Okinawa (Japan), Sardinia (Italy), Nicoya (Costa Rica), Icaria (Greece) and a group of Seventh-day Adventists living in Loma Linda (US, California). The Cilento, a mountainous region 150 kilometres south from Naples, is another hotspot of centenarians. Although it didn’t earn a mention in Buettner’s book on the so-called “Blue zones” of centenarians, people who live there are getting older than in Okinawa, Japan, the world's very best-studied longevity hot-spot. Life expectation of women living in the Cilento (92 years) is 8 years above the Italian average; and that of men (85 years) 6 years above, anyway.
Adrenomedullin
is a soluble peptide hormone. Mainly released by the inner layer of blood vessels (endothelial cells), its biological function is to control vasodilation, an important regulator of blood pressure and organ perfusion. In several studies involving more than 16.000 patients, the plasma level of the bioactive Adrenomedullin (bio-ADM) has been proven to predict and provide an early diagnosis for circulation dysfunction. For instance, bio-ADM blood levels rise 2-3 days before septic shock occurs. Elevated levels of bio-ADM are a specific indicator of vasodilation and leakage from microcirculatory capillaries, which in sepsis patients subsequently lead to severe hypotension, malperfusion of organs (for which the body can’t compensate by increasing the heart rate), shock and multiple organ failure. Low bio-ADM blood levels, in contrast, are a specific indicator for an intact microcirculation, ensuring good muscle and organ blood supply without any cardiovascular stress.
SphingoTec GmbH
(Hennigsdorf, Germany) develops innovative biomarkers for the early diagnosis, prediction and monitoring of severe medical conditions, such as cardiovascular diseases, sepsis, kidney dysfunction and cancer, supporting treatment and prevention strategies.
Located on the outskirts of Berlin, the company was established in 2002. Its founder Dr. Andreas Bergmann was one of the founders of B.R.A.H.M.S. AG, which has become part of ThermoFisher Scientific. As the company‘s former Chief Research Officer, he was responsible for the development of the “gold standard” sepsis biomarker Procalcitonin (B.R.A.H.M.S. PCT™).
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• PenKid surpasses serum creatinine on Day 1 post-transplant in detecting delayed graft function (DGF), with an AUROC of 0.87 versus 0.56 for creatinine. • PenKid differentiates slow graft function (SGF) from DGF up to 8 days earlier than current methods, supporting more timely clinical decisions. • PenKid levels remain unaffected by kidney replacement therapy (KRT), allowing for more accurate assessment of kidney function. • Independent validation in transplant cohort from Australia confirms performance and broad applicability. Hennigsdorf/Berlin, Germany, July 1, 2025 - Diagnostic company SphingoTec GmbH (“SphingoTec”) announces a landmark study (1) published in Transplant International, led by Heidelberg University Hospital in Germany in collaboration with researchers from Sydney, Australia, which identifies Proenkephalin A 119-159 (penKid) as a reliable biomarker for early and precise assessment of graft function trajectories following kidney transplantation. The research demonstrates that PenKid not only identifies patients at risk for DGF significantly earlier than traditional markers but also distinguishes between slow and delayed graft function with remarkable accuracy, offering clinicians a valuable new tool for patient management. The study prospectively evaluated 159 consecutive kidney transplant recipients at Heidelberg University Hospital and validated findings in an independent cohort from Sydney. PenKid consistently outperformed serum creatinine (SCr) in predicting graft function trajectories, particularly in the critical early post-transplant period. Notably, PenKid’s ability to remain unaffected by KRT—a treatment for severe kidney dysfunction—further sets it apart from SCr, which can be influenced by non-renal factors and KRT itself, thereby enhancing the reliability of graft function assessment. Multivariate analysis confirmed PenKid as the strongest independent predictor of both short-term graft function and 30-day outcomes, underscoring its clinical utility for early risk stratification. The biomarker’s superior granularity allows for nuanced classification of DGF severity, supporting more informed decisions regarding the initiation of dialysis or biopsy and offering potential for individualized patient care. With these findings, penKid steps forward as a practical addition to the transplant clinician’s toolkit, promising to sharpen decision-making for optimal outcomes. Its adoption could help transplant teams act with greater confidence and precision, ultimately strengthening the standard of care in kidney transplantation. ## References 1. Benning L et al. (2025) Proenkephalin A 119-159 in Kidney Transplantation: A Novel Biomarker for Superior Tracking of Graft Function Trajectories. Transpl. Int. 38:14366. doi: 10.3389/ti.2025.14366 About SphingoTec SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a biomarker company focusing on the out-licensing of innovative critical care solutions for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, commercially available on diagnostic platforms AFIAS and Nexus IB10 and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like sepsis. Discover more on www.sphingotec.com Contact : Ruxandra Lenz Marketing and Communication SphingoTec GmbH Phone +49-3302-20565-0 Email: press@sphingotec.com

• Boditech Med and SphingoTec announce the launch of the AFIAS sphingotest® penKid® assay, a diagnostic tool designed to aid in kidney function assessment for critically ill patients. • The IVDR-marked assay provides quantitative measurements of Proenkephalin A 119-159 (penKid), supporting clinical decision-making in acute and critical care. • This launch follows a licensing agreement granting Boditech the rights to develop and commercialize penKid-based assays, as well as a market development agreement between the two companies. Gangwon-do, Republic of Korea, and Hennigsdorf/Berlin, Germany, May 6, 2025 - Boditech Med Inc. (“Boditech”) and SphingoTec GmbH (“SphingoTec”) today announced the commercial launch of the AFIAS sphingotest® penKid® assay. The assay is designed to provide clinicians with a tool for assessing kidney function in critically ill patients by measuring Proenkephalin A 119-159 (penKid), a biomarker that reflects real-time kidney function independently of inflammation or comorbidities. The AFIAS sphingotest® penKid® assay is IVDR-marked for its intended use as an automated fluorescence immunoassay for the in vitro diagnostic quantitative determination of Proenkephalin A 119-159 in human whole blood/plasma, serving as an aid in the diagnosis of acute kidney injury (AKI) in adult patients with sepsis or septic shock. It provides additional information to support clinical decision-making in managing critically ill patients at risk of acute kidney injury (AKI). This launch is the result of a strategic collaboration between Boditech and SphingoTec, including a licensing agreement granting Boditech the rights to develop and commercialize penKid-based assays on its diagnostic platforms, as well as a market development agreement aimed at accelerating global commercialization efforts. Eui-Yul Choi, CEO of Boditech Med, commented: “We are proud to introduce the AFIAS sphingotest® penKid® assay to clinicians worldwide. This launch reflects our commitment to delivering innovative diagnostic solutions that address critical needs in healthcare. Our collaboration with SphingoTec has been instrumental in bringing this important tool to market.” Deborah Bergmann, CEO of SphingoTec, added: “The launch of AFIAS sphingotest® penKid® demonstrates how partnerships can drive innovation and improve access to advanced diagnostics. By combining our biomarker expertise with Boditech’s diagnostic capabilities, we are reaching a new chapter in our collaboration. We are streamlining our processes to support the business of our license partners and further expand our global reach. This enables us to provide clinicians with essential tools to enhance patient care.” Scientific insights on penKid PenKid is a biomarker that enables real-time assessment of kidney function (1). Unlike traditional markers such as serum creatinine, penKid levels are not influenced by inflammation or other confounding factors like age or sex (1,2,3). Studies have shown that penKid allows earlier detection of acute kidney injury (AKI), predicting changes in serum creatinine up to 48 hours before conventional diagnostic criteria are met (1,3). This early detection capability is particularly valuable in critically ill patients, including those with sepsis or septic shock (1,3,4). Additionally, penKid has shown potential for monitoring renal recovery under dialysis and could help predict successful weaning from renal replacement therapy (5,6). ## References 1. Hollinger A, et.al. Proenkephalin A 119-159 (Penkid) Is an Early Biomarker of Septic Acute Kidney Injury: The Kidney in Sepsis and Septic Shock (Kid-SSS) Study. Kidney Int Rep. 2018 Aug 22;3(6):1424-1433. doi: 10.1016/j.ekir.2018.08.006. 2. Beunders et al. Assessing GFR With Proenkephalin, Kidney International Reports, 2023, DOI: https://doi.org/10.1016/j.ekir.2023.08.006 3. Caironi et al., Circulating proenkephalin, acute kidney injury, and its improvement in patients with severe sepsis or shock. Clin Chem (2018) DOI:10.1373/clinchem.2018.288068 4. Moledina DG. Penkid: A Novel Biomarker of Reduced GFR in Sepsis. Kidney Int Rep. 2018 Nov 15;4(1):17-19. doi: 10.1016/j.ekir.2018.11.002. 5. von Groote T et al. Proenkephalin A 119–159 predicts early and successful liberation from renal replacement therapy in critically ill patients with acute kidney injury: a post hoc analysis of the ELAIN trial. Crit Care 26, 333 (2022). doi.org/10.1186/s13054-022-04217-4 6. von Groote T, et al. Evaluation of Proenkephalin A 119-159 for liberation from renal replacement therapy: an external, multicenter pilot study in critically ill patients with acute kidney injury. Crit Care. 2023 Jul 10;27(1):276. doi: 10.1186/s13054-023-04556-w. About Boditech Boditech Med (based in Chuncheon, Gangwon-do, Republic of Korea) is a leading company in the field of point-of-care diagnostics, which has accumulated 25 years of business expertise in the field. The company has more than 80 types of in vitro diagnostic products that detect biomarkers related to infectious diseases, diabetes, cardiovascular diseases, cancer, and hormone-related diseases with its immunofluorescence lateral flow technology, quantitative immunofluorescence technology and spectrophotometric technology. And the list continues to grow with new high-value-added products. With its instrument platform installed in more than 120 countries, the company also has a stable revenue model. The company is currently strengthening its value as a global company by expanding its manufacturing bases in the US, China, India, and Indonesia. About SphingoTec SphingoTec GmbH ("SphingoTec"; Hennigsdorf near Berlin, Germany) is a diagnostic company focusing on the out-licensing of innovative critical care biomarkers for diagnosing, predicting, and monitoring acute medical conditions. SphingoTec develops its biomarkers to the commercial stage and partners with IVD companies to make them available on different IVD platforms. SphingoTec's proprietary biomarker portfolio includes Proenkephalin A 119-159 (penKid), a biomarker for the assessment of kidney function in critical diseases, commercially available on diagnostic platforms AFIAS and Nexus IB10 and bioactive Adrenomedullin 1-52 (bio-ADM), a biomarker for the assessment of endothelial function in conditions like sepsis. Discover more on www.sphingotec.com Contact: Ruxandra Lenz Head of Marketing and Communication SphingoTec GmbH Phone +49-3302-20565-0 Email: press@sphingotec.com
