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董 明, 王 喜, 焦 富, 张 维. [Research advances in genetic polymorphisms in Kawasaki disease]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:1234-1238. [PMID: 38112140 PMCID: PMC10731961 DOI: 10.7499/j.issn.1008-8830.2308073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/31/2023] [Indexed: 12/20/2023]
Abstract
Kawasaki disease (KD) is a systemic inflammatory vascular disorder that predominantly affects children and is the leading cause of acquired heart disease in children. Although the etiology of this disease remains unclear, genome-wide association and genome-wide linkage studies have shown that some susceptible genes and chromosomal regions are associated with the development and progression of KD. With the advancement of high-throughput DNA sequencing techniques, more and more genomic information related to KD is being discovered. Understanding the genes involved in the pathogenesis of KD may provide novel insights into the diagnosis and treatment of KD. By analyzing related articles and summarizing related research advances, this article mainly discusses the T cell activation-enhancing genes that have been confirmed to be closely associated with the development and progression of KD and reveals their association with the pathogenesis of KD and coronary artery lesions.
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Affiliation(s)
| | | | - 富勇 焦
- 陕西省川崎病诊疗中心/陕西省人民医院 儿童病院,陕西西安710068
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2
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Chen W, Chen S, Tian Y, Liu Y, Chen C, Wang B, Chen C, Liu F. A LncRNA gene polymorphism (rs1814343) is associated with the risk of coronary artery lesions in southern Chinese Kawasaki disease patients. J Gene Med 2023:e3514. [PMID: 37097087 DOI: 10.1002/jgm.3514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Kawasaki disease (KD) is a multisystemic angiitis, and its most disastrous complication is coronary artery lesions (CALs). Recently, the role of long non-coding RNAs (lncRNAs) in KD has been reported. rs1814343 is a lncRNA, but the relationship between the lncRNA rs1814343 polymorphism and KD risk remains elusive. METHODS We enrolled 1625 Kawasaki disease patients (583 patients with CAL and 1042 without CAL) and 1000 healthy controls from a southern Chinese population. We genotyped the rs1814343 C > T polymorphism in KD and control patients using the TaqMan method. The odds ratio (OR) and 95% confidence interval (CI) were used to estimate the strength of the association. RESULTS There was no significant association between the lncRNA rs1814343 C > T polymorphism and KD susceptibility. However, we stratified patients in this study by CAL and sex. First, compared with the control groups, we found that the rs1814343 genotype increased risk for KD patients with CAL (TT vs. CC + CT: OR = 1.36, 95% CI = 1.08-1.71, p = 0.009). Moreover, when KD patients were stratified by CAL, the TT genotypes of this lncRNA polymorphism contributed to a relatively higher occurrence of KD with CAL than that was found in the CC/CT genotype patients (TT vs. CC + CT: OR = 1.35, 95% CI = 1.07-1.69, p = 0.011). In addition, our research suggested that the TT variant genotype in the lncRNA rs1814343 had an obvious risk of KD with CAL susceptibility in male children. CONCLUSION The lncRNA rs1814343 C > T polymorphism was related to higher susceptibility of KD with CAL.
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Affiliation(s)
- Wenchao Chen
- Department of Cardiology and Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuo Chen
- Emergency Department, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yan Tian
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanqing Liu
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Cheng Chen
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Bingtong Wang
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Chongfeng Chen
- Department of Cardiology and Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Fucheng Liu
- Department of Cardiology and Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Exploring the Mechanism of Aspirin in the Treatment of Kawasaki Disease Based on Molecular Docking and Molecular Dynamics. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9828518. [PMID: 35990842 PMCID: PMC9391120 DOI: 10.1155/2022/9828518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/26/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
Purpose The research aims to investigate the mechanism of action of aspirin in the treatment of Kawasaki disease. Methods We predicted the targets of aspirin with the help of the Drugbank and PharmMapper databases, the target genes of Kawasaki disease were mined in the GeneCards and Disgenet databases, the intersection targets were processed in the Venny database, and the gene expression differences were observed in the GEO database. The Drugbank and PharmMapper databases were used to predict the target of aspirin, and the target genes of Kawasaki disease were explored in the GeneCards and Disgenet databases, and the Venny was used for intersection processing. We observed the gene expression differences in the GEO database. The disease-core gene target-drug network was established and molecular docking was used for verification. Molecular dynamics simulation verification was carried out to combine the active ingredient and the target with a stable combination. The supercomputer platform was used to measure and analyze the binding free energy, the number of hydrogen bonds, the stability of the protein target at the residue level, the radius of gyration, and the solvent accessible surface area. Results Aspirin had 294 gene targets, Kawasaki disease had 416 gene targets, 42 intersecting targets were obtained, we screened 13 core targets by PPI; In the GO analysis, we learned that the biological process of Kawasaki disease involved the positive regulation of chemokine biosynthesis and inflammatory response; pathway enrichment involved PI3K-AKT signaling pathway, tumor necrosis factor signaling pathway, etc. After molecular docking, the data showed that CTSG, ELANE, and FGF1 had the best binding degree to aspirin. Molecular dynamics was used to prove and analyze the binding stability of active ingredients and protein targets, and Aspirin/ELANE combination has the strongest binding energy. Conclusion In the treatment of Kawasaki disease, aspirin may regulate inflammatory response and vascular remodeling through CTSG, ELANE, and FGF1.
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Pino R, Izurieta AC, Ríos-Barnés M, Ricart S, De Sevilla MF, Monfort L, Launes C, Cano I, Lecina L, Sánchez Manubens J, Mosquera JM, Jordan I, Sánchez de Toledo J, Monsonís M, Esteva C, Muñoz-Almagro C, Fumadó V, Fortuny C, Garcia Garcia JJ, Noguera-Julian A, Anton J. Correspondence on: 'Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort' by Pouletty et al. Ann Rheum Dis 2022; 81:e159. [PMID: 32759264 DOI: 10.1136/annrheumdis-2020-218538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Rosa Pino
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ana Carolina Izurieta
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - María Ríos-Barnés
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Sílvia Ricart
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Mariona F De Sevilla
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Laura Monfort
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristian Launes
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Iván Cano
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Laura Lecina
- Hospital Medicine Unit, Pediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Judith Sánchez Manubens
- Pediatric Rheumatology Unit, Hospital Sant Joan de Déu, Barcelona, Spain
- Pediatric Rheumatology, Consorcio Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | - Iolanda Jordan
- CIBERESP, Madrid, Spain
- Pediatric Intensive Care Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Joan Sánchez de Toledo
- Pediatric Cardiology Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Critical Care Medicine, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Manuel Monsonís
- Department of Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristina Esteva
- CIBERESP, Madrid, Spain
- Department of Molecular Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carmen Muñoz-Almagro
- CIBERESP, Madrid, Spain
- Department of Molecular Microbiology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Victòria Fumadó
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Hospital Sant Joan de Déu, Barcelona, Spain
- Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Clàudia Fortuny
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Juan José Garcia Garcia
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Antoni Noguera-Julian
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Hospital Sant Joan de Déu, Barcelona, Spain
- CIBERESP, Madrid, Spain
| | - Jordi Anton
- Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
- Pediatric Rheumatology Unit, Hospital Sant Joan de Déu, Barcelona, Spain
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Gut Microbiota Dysbiosis in Childhood Vasculitis: A Perspective Comparative Pilot Study. J Pers Med 2022; 12:jpm12060973. [PMID: 35743758 PMCID: PMC9224684 DOI: 10.3390/jpm12060973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022] Open
Abstract
Kawasaki disease (KD) and Henoch–Schönlein purpura (HSP) are the most frequent vasculitis in childhood. For both, a multifactorial mechanism has been hypothesised, with an abnormal immune response in genetically predisposed children. Gut microbiota (GM) alterations might trigger the hyperimmune reaction. Our aim was to explore the GM in KD and compare it with the GM of HSP and febrile children. Children diagnosed with KD, HSP and non-KD febrile illness (F) were enrolled. GM was profiled by 16S rRNA gene sequencing and compared with the profiles of healthy children from previous studies. We enrolled 13 KD, 10 HSP and 12 F children. Their GM significantly differed from controls, with an overall reduction in the relative abundance of beneficial taxa belonging to the Ruminococcaceae and Lachnospiraceae families. Potential KD and HSP signatures were identified, including smaller amounts of Dialister in the former, and Clostridium and Akkermansia in the latter. Notably, the GM structures of KD, HSP and F patients stratified by abdominal involvement, with more severe dysbiosis in those suffering from intestinal symptoms. This is the first study analysing GM in a mostly Caucasian cohort of KD and HSP children. Our data could open up new opportunities for childhood vasculitis treatment.
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Liu D, Song M, Jing F, Liu B, Yi Q. Diagnostic Value of Immune-Related Genes in Kawasaki Disease. Front Genet 2021; 12:763496. [PMID: 34956318 PMCID: PMC8709561 DOI: 10.3389/fgene.2021.763496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/11/2021] [Indexed: 12/19/2022] Open
Abstract
Kawasaki disease (KD) is a systemic vasculitis that predominantly damages medium- and small-sized vessels, and mainly causes coronary artery lesions (CALs). The diagnostic criterion of KD mainly depends on clinical features, so children could be easily misdiagnosed and could suffer from CALs. Through analysis, a total of 14 immune-related DEGs were obtained, of which IL1B, ADM, PDGFC, and TGFA were identified as diagnostic markers of KD. Compared with the non-KD group, KD patients contained a higher proportion of naive B cells, activated memory CD4 T cells, gamma delta T cells, and neutrophils, while the proportions of memory B cells, CD8 T cells, activated memory CD4 T cells, and activated NK cells were relatively lower. In conclusion, immune-related genes can be used as diagnostic markers of KD, and the difference in immune cells between KD and non-KD might provide new insight into understanding the pathogenesis of KD.
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Affiliation(s)
- Dong Liu
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Department of Pediatrics, Sichuan Clinical Research Center for Birth Defects, The Affliated Hospital of Southwest Medical University, Luzhou, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Meixuan Song
- Department of Gastrointestinal Surgery, The Affliated Hospital of Southwest Medical University, Luzhou, China
| | - Fengchuan Jing
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Bin Liu
- Department of Pediatrics, Sichuan Clinical Research Center for Birth Defects, The Affliated Hospital of Southwest Medical University, Luzhou, China
| | - Qijian Yi
- Department of Cardiovascular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
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7
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Patra PK, Das RR, Banday AZ, Singh M, Goyal K, Jindal AK, Singh S. Non-SARS, non-MERS human coronavirus infections and risk of Kawasaki disease: a meta-analysis. Future Virol 2021. [PMID: 34858515 PMCID: PMC8629369 DOI: 10.2217/fvl-2021-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/01/2021] [Indexed: 11/21/2022]
Abstract
Aim: To study the association between non-SARS, non-MERS human coronavirus (HCoV) infections and Kawasaki disease (KD). Methods: Meta-analysis of observational studies published until 1 May 2021. Results: Out of 571 papers retrieved through database search, 10 provided data of 17,732 children. Age ranged from 2 months-14.9 years with 66% being male and 71% being complete KD. Compared with controls, there was an increased risk of developing KD in those detected to have HCoV infection (OR: 2.3 [95% CI: 1.06-4.99]; p = 0.03). The GRADE evidence for all outcomes was of 'low-certainty'. Conclusion: A 'low certainty' of evidence suggests an increased risk of KD in children infected with HCoV. We need multi-center, prospective studies to support or refute this finding. PROSPERO protocol registration: CRD42021251582.
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Affiliation(s)
- Pratap Kumar Patra
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, 801507, India
| | - Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, India
| | - Aaqib Zaffar Banday
- Department of Pediatrics, Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Mini Singh
- Department of Virology, PGIMER, Chandigarh, 160012, India
| | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, 160012, India
| | - Ankur Kumar Jindal
- Department of Pediatrics, Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Surjit Singh
- Department of Pediatrics, Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
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Leyens J, Bender TTA, Mücke M, Stieber C, Kravchenko D, Dernbach C, Seidel MF. The combined prevalence of classified rare rheumatic diseases is almost double that of ankylosing spondylitis. Orphanet J Rare Dis 2021; 16:326. [PMID: 34294115 PMCID: PMC8296612 DOI: 10.1186/s13023-021-01945-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare diseases (RDs) affect less than 5/10,000 people in Europe and fewer than 200,000 individuals in the United States. In rheumatology, RDs are heterogeneous and lack systemic classification. Clinical courses involve a variety of diverse symptoms, and patients may be misdiagnosed and not receive appropriate treatment. The objective of this study was to identify and classify some of the most important RDs in rheumatology. We also attempted to determine their combined prevalence to more precisely define this area of rheumatology and increase awareness of RDs in healthcare systems. We conducted a comprehensive literature search and analyzed each disease for the specified criteria, such as clinical symptoms, treatment regimens, prognoses, and point prevalences. If no epidemiological data were available, we estimated the prevalence as 1/1,000,000. The total point prevalence for all RDs in rheumatology was estimated as the sum of the individually determined prevalences. RESULTS A total of 76 syndromes and diseases were identified, including vasculitis/vasculopathy (n = 15), arthritis/arthropathy (n = 11), autoinflammatory syndromes (n = 11), myositis (n = 9), bone disorders (n = 11), connective tissue diseases (n = 8), overgrowth syndromes (n = 3), and others (n = 8). Out of the 76 diseases, 61 (80%) are classified as chronic, with a remitting-relapsing course in 27 cases (35%) upon adequate treatment. Another 34 (45%) diseases were predominantly progressive and difficult to control. Corticosteroids are a therapeutic option in 49 (64%) syndromes. Mortality is variable and could not be determined precisely. Epidemiological studies and prevalence data were available for 33 syndromes and diseases. For an additional eight diseases, only incidence data were accessible. The summed prevalence of all RDs was 28.8/10,000. CONCLUSIONS RDs in rheumatology are frequently chronic, progressive, and present variable symptoms. Treatment options are often restricted to corticosteroids, presumably because of the scarcity of randomized controlled trials. The estimated combined prevalence is significant and almost double that of ankylosing spondylitis (18/10,000). Thus, healthcare systems should assign RDs similar importance as any other common disease in rheumatology.
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Affiliation(s)
- Judith Leyens
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
- Department of Neonatology and Pediatric Care, Children's University Hospital, Bonn, Germany
| | - Tim Th A Bender
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
- Institute of Human Genetics, University Hospital, Bonn, Germany
| | - Martin Mücke
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
| | - Christiane Stieber
- Institute of General Practice and Family Medicine, University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Dmitrij Kravchenko
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
- Department of Radiology, University Hospital, Bonn, Germany
| | - Christian Dernbach
- Division of Medical Psychology and Department of Psychiatry, University Hospital, Bonn, Germany
| | - Matthias F Seidel
- Department of Rheumatology, Spitalzentrum-Centre hospitalier, Biel-Bienne, Switzerland.
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Yuan J, Jiang Z, Li M, Li W, Gu X, Wang Z, Pi L, Xu Y, Zhou H, Zhang B, Deng Q, Wang Y, Huang P, Zhang L, Gu X. Integrin α2 gene polymorphism is a risk factor of coronary artery lesions in Chinese children with Kawasaki disease. Pediatr Rheumatol Online J 2021; 19:12. [PMID: 33557870 PMCID: PMC7869497 DOI: 10.1186/s12969-021-00494-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kawasaki disease (KD) is a systemic vasculitis, and the formation of coronary artery lesions(CAL) is its most common sequela. Both genetic and environmental factors are considered to be important factors of in KD. Integrin α2 (ITGA2) is a transmembrane receptor that is associated with susceptibility to several diseases, but its relevance to KD with CAL is unclear. METHODS We genotyped ITGA2 rs1126643 in 785 KD patients with the CAL and no-CAL(NCAL) (300 patients with CAL, and 485 age- and sex-matched patients with NCAL). OR (95% CI) and adjusted OR (95% CI) were used to evaluate the intensity of the association. RESULTS We found a significantly increased risk of KD with CAL associated with ITGA2 rs1126643 genotypes (CT vs CC: adjusted OR = 1.57, 95% CI = 1.16-2.12, P = 0.0032; CT/TT vs CC: adjusted OR = 1.49, 95% CI = 1.12-2.00, P = 0.0068; T vs C: adjusted OR = 1.66, 95% CI = 1.16-2.51, P = 0.0165). Moreover, we found that carriers of the CT/TT genotype had a significant risk of KD with coronary artery lesion susceptibility for children ≤60 months of age, and the CT/TT genotype was significantly associated with an increased risk of SCAL formation and MCAL formation when compared with the CC genotype. CONCLUSION ITGA2 rs1126643 was associated with increased susceptibility and severity of CAL in KD.
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Affiliation(s)
- Jia Yuan
- grid.410737.60000 0000 8653 1072Department of Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Zhiyong Jiang
- grid.410737.60000 0000 8653 1072Department of Blood Transfusion and Clinical Lab, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Meiai Li
- grid.410737.60000 0000 8653 1072Department of Clinical Lab, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Wei Li
- grid.410737.60000 0000 8653 1072Department of Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Xueping Gu
- grid.410737.60000 0000 8653 1072Department of Blood Transfusion and Clinical Lab, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Zhouping Wang
- grid.410737.60000 0000 8653 1072Department of Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Lei Pi
- grid.410737.60000 0000 8653 1072Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Yufen Xu
- grid.410737.60000 0000 8653 1072Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Huazhong Zhou
- grid.410737.60000 0000 8653 1072Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Baidu Zhang
- grid.410737.60000 0000 8653 1072Department of Clinical Lab, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Qiulian Deng
- grid.410737.60000 0000 8653 1072Department of Clinical Lab, Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Yanfei Wang
- grid.410737.60000 0000 8653 1072Department of Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Ping Huang
- grid.410737.60000 0000 8653 1072Department of Cardiology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong China
| | - Li Zhang
- Department of Cardiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
| | - Xiaoqiong Gu
- Department of Blood Transfusion , Clinical Biological Resource Bank and Clinical Lab, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
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10
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Marchesi A, Rigante D, Cimaz R, Ravelli A, Tarissi de Jacobis I, Rimini A, Cardinale F, Cattalini M, De Zorzi A, Dellepiane RM, Salice P, Secinaro A, Taddio A, Palma P, El Hachem M, Cortis E, Maggio MC, Corsello G, Villani A. Revised recommendations of the Italian Society of Pediatrics about the general management of Kawasaki disease. Ital J Pediatr 2021; 47:16. [PMID: 33494789 PMCID: PMC7830049 DOI: 10.1186/s13052-021-00962-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/04/2021] [Indexed: 12/19/2022] Open
Abstract
Aim of these revised recommendations for the general management of Kawasaki disease is to encourage its prompter recognition and warrant the most appropriate therapy, based on ascertained scientific data, raising awareness of the complications related to misdiagnosis or delayed treatment. A set of 20 synthetic operative statements is herein provided, including the definition of Kawasaki disease, its protean presentations, clinical course and seminal treatment modalities of all disease phases. The application of these recommendations should improve prognosis of Kawasaki disease and prevent the progression to permanent vascular abnormalities, thereby diminishing morbidity and mortality.
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Affiliation(s)
| | - Donato Rigante
- Department of Life Sciences and Public Health, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.,Università Cattolica Sacro Cuore, Rome, Italy
| | - Rolando Cimaz
- Pediatric Rheumatology, ASST Gaetano Pini-CTO, Milan, Italy. .,University of Milan, Milan, Italy.
| | - Angelo Ravelli
- Pediatrics and Rheumatology Unit, IRCCS Istituto Giannina Gaslini, University of Genoa, Genoa, Italy
| | | | | | - Fabio Cardinale
- Department of Pediatrics, AOU Policlinico Giovanni XXIII, Bari, Italy
| | - Marco Cattalini
- Pediatrics Clinic, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Rosa Maria Dellepiane
- UOC of Pediatrics, UOS of Pediatric Immunology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Patrizia Salice
- Section of Pediatric Cardiovascular Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Andrea Taddio
- University of Trieste, Trieste, Italy.,Institute of Child and Maternal Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Paolo Palma
- Bambino Gesù Children's Hospital, Rome, Italy
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Banoo N, Bashir A, Tariq S, Radhakrishnan S, Abid S. Clinical profile of Kawasaki disease in children admitted at a tertiary care hospital of North India and their short-term follow-up. Ann Pediatr Cardiol 2021; 14:459-464. [PMID: 35527772 PMCID: PMC9075575 DOI: 10.4103/apc.apc_201_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/07/2020] [Accepted: 01/27/2021] [Indexed: 11/05/2022] Open
Abstract
Aim: The aim of this study was to evaluate presenting symptoms, clinical features, and laboratory tests for the diagnosis of Kawasaki disease (KD) in children and their short-term follow-up at a tertiary care hospital of North India from April 2017 to March 2020. Materials and Methods: A total of 31 children (23 boys and 8 girls) up to 10 years of age were included in this study. The diagnosis of KD was made as per the American Heart Association 2017 guidelines. Clinical features, laboratory parameters, and coronary involvement were compared between the complete and incomplete KD groups. Results: The incidence of complete versus incomplete KD was 19 (61.2%) versus 12 (38.7%) children, respectively. Change in extremities and oral mucosal changes were more encountered in the complete KD group as compared to the incomplete KD group (100% vs. 58.3%, P = 0.004, and 78.9% vs. 33.3%, P = 0.002, respectively). Coronary artery aneurysm was seen in 54% of the patients on echocardiography which was greater in the incomplete KD group (83.3%) as compared to the complete KD group (36.8%). The median time from the onset of symptoms to intravenous immunoglobulin infusion was <10 days in 84.2% of the patients with complete KD versus 41.7% with incomplete KD which was statistically significant. Fifty percent of the children with coronary ectasia and small aneurysm had normal coronaries at follow-up of 6 months. Conclusion: KD is probably underdiagnosed in most developing countries, like that of ours, and requires a high index of suspicion.
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Buteau S, Belkaibech S, Bilodeau-Bertrand M, Hatzopoulou M, Smargiassi A, Auger N. Association between Kawasaki Disease and Prenatal Exposure to Ambient and Industrial Air Pollution: A Population-Based Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:107006. [PMID: 33074736 PMCID: PMC7571626 DOI: 10.1289/ehp6920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Environmental factors may contribute to the development of Kawasaki disease in children, but prenatal environmental exposures are understudied. OBJECTIVE We used a population-based cohort to investigate whether prenatal exposure to outdoor air pollution is associated with the incidence of Kawasaki disease in childhood. METHODS We performed a longitudinal cohort study of all children born in Quebec, Canada, between 2006 and 2012. Children were followed for Kawasaki disease from birth until 31 March 2018. We assigned prenatal air pollutant exposure according to the residential postal code at birth. The main exposure was annual average concentration of ambient fine particulate matter [PM ≤2.5μm in aerodynamic diameter (PM2.5) and nitrogen dioxide (NO2) from satellite-based estimates and land-use regression models. As secondary exposures, we considered industrial PM2.5, NO2, and sulfur dioxide (SO2) emissions estimated from dispersion models. We estimated hazard ratios (HRs) using Cox proportional hazards models, adjusted for maternal age, parity, sex, multiple birth, maternal smoking during pregnancy, socioeconomic status, birth year, and rural residence. We considered single and multipollutant models. We performed several sensitivity analyses, including assessing modifying effects of maternal comorbidities (e.g., diabetes, preeclampsia). RESULTS The cohort comprised 505,336 children, including 539 with Kawasaki disease. HRs for each interquartile range increase in ambient air pollution were 1.16 (95% CI: 0.96, 1.39) for PM2.5 and 1.12 (95% CI: 0.96, 1.31) for NO2. For industrial air pollution, HRs were 1.07 (95% CI: 1.01, 1.13) for SO2, 1.09 (95% CI: 0.99, 1.20) for NO2, and 1.01 (95% CI: 0.97, 1.05) for PM2.5. In multipollutant models, associations for ambient PM2.5 and NO2 (i.e., from all sources) were robust to adjustment for industrial pollution, and vice versa. DISCUSSION In this population-based cohort study, both prenatal exposure to ambient and industrial air pollution were associated with the incidence of Kawasaki disease in childhood. Further studies are needed to consolidate the observed associations. https://doi.org/10.1289/EHP6920.
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Affiliation(s)
- Stephane Buteau
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Canada
| | - Sabrina Belkaibech
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Engineering and Health Management, University of Lille, Lille, France
| | | | - Marianne Hatzopoulou
- Department of Civil Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Audrey Smargiassi
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Canada
- Public Health Research Institute, University of Montreal, Montreal, Quebec, Canada
| | - Nathalie Auger
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- University of Montreal Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada
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Santos BSD, Santos FSD, Ribeiro ER. CLINICAL-EPIDEMIOLOGICAL RELATION BETWEEN SARS-COV-2 AND KAWASAKI DISEASE: AN INTEGRATIVE LITERATURE. ACTA ACUST UNITED AC 2020; 39:e2020217. [PMID: 32876096 PMCID: PMC7461695 DOI: 10.1590/1984-0462/2021/39/2020217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/12/2020] [Indexed: 12/23/2022]
Abstract
Objective: To analyze the current scientific literature to document, in an integrative
review, the main findings that correlate Kawasaki disease (KD) to
COVID-19. Data sources: The search was carried out in June 2020 in the following databases:
Biblioteca Virtual em Saúde (BVS), periódico da
CAPES and U.S National Library of Medicine (PubMed). The
combination of descriptors used was [(COVID-19 OR SARS-CoV-2) AND (Kawasaki
disease)], and the inclusion criteria stipulated were studies published from
January 2019 to June 2020, without restriction of language or location, and
available online in full. News, editorials, comments, and letters, as well
as duplicates and articles that did not answer the guiding question were
excluded. Data synthesis: A total of 97 articles were identified, of which seven comprised this
review. The association of KD to the new coronavirus appears to trigger a
severe clinical condition of vasculitis. Different from the usual, in this
inflammatory syndrome, patients are older, and prevalence is higher in
children from African or Caribbean ancestry; clinical and laboratory
manifestations are also atypical, with a predominance of abdominal
complaints and exaggerated elevation of inflammatory markers. In addition,
there was a greater report of rare complications and greater resistance to
the recommended treatment for KD. Conclusions: Pediatric COVID-19 and its potential association to severe KD, still
unfamiliar to health professionals, reinforces the importance of testing
patients with vasculitis for the new coronavirus and the need to wage high
surveillance and preparation of the health system during the current
pandemic.
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Shibata S, Arima H, Asayama K, Hoshide S, Ichihara A, Ishimitsu T, Kario K, Kishi T, Mogi M, Nishiyama A, Ohishi M, Ohkubo T, Tamura K, Tanaka M, Yamamoto E, Yamamoto K, Itoh H. Hypertension and related diseases in the era of COVID-19: a report from the Japanese Society of Hypertension Task Force on COVID-19. Hypertens Res 2020; 43:1028-1046. [PMID: 32737423 PMCID: PMC7393334 DOI: 10.1038/s41440-020-0515-0] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected more than seven million people worldwide, contributing to 0.4 million deaths as of June 2020. The fact that the virus uses angiotensin-converting enzyme (ACE)-2 as the cell entry receptor and that hypertension as well as cardiovascular disorders frequently coexist with COVID-19 have generated considerable discussion on the management of patients with hypertension. In addition, the COVID-19 pandemic necessitates the development of and adaptation to a “New Normal” lifestyle, which will have a profound impact not only on communicable diseases but also on noncommunicable diseases, including hypertension. Summarizing what is known and what requires further investigation in this field may help to address the challenges we face. In the present review, we critically evaluate the existing evidence for the epidemiological association between COVID-19 and hypertension. We also summarize the current knowledge regarding the pathophysiology of SARS-CoV-2 infection with an emphasis on ACE2, the cardiovascular system, and the kidney. Finally, we review evidence on the use of antihypertensive medication, namely, ACE inhibitors and angiotensin receptor blockers, in patients with COVID-19.
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Affiliation(s)
- Shigeru Shibata
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshihiko Ishimitsu
- Department of Nephrology and Hypertension, Dokkyo Medical University, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Takuya Kishi
- Department of Graduate School of Medicine (Cardiology), International University of Health and Welfare, Fukuoka, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masami Tanaka
- Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Itoh
- Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo, Japan
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15
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The Platelet microRNA Profile of Kawasaki Disease: Identification of Novel Diagnostic Biomarkers. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9061568. [PMID: 32733962 PMCID: PMC7383328 DOI: 10.1155/2020/9061568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/17/2020] [Accepted: 05/21/2020] [Indexed: 12/22/2022]
Abstract
Challenging diagnosis and unknown etiology of Kawasaki disease (KD) increase the coronary artery lesions incidence. microRNAs (miRNAs) are the most promising biomarkers because of their stability in peripheral blood and noninvasive measurement procedure, whose potential utility have been proved in cancers. To explore the utility of differentially expressed (DE) miRNAs as early diagnostic markers, 44 patients (25 incomplete KD and 19 complete KD) and 31 febrile controls were recruited for small RNA sequencing. From all the 1922 expressed miRNA, 210 DE miRNAs were found between KD and febrile control groups. Though platelet miRNA profiles of complete KD incomplete KD were much similar through cluster analysis, the DE miRNAs were not identical. Eight DE miRNAs were validated by real-time quantitative PCR (qRT-PCR) in complete or incomplete KD groups using a normalizer, miR-126-3p, which was identified by geNorm and NormFinder tools. The expression level of miRNAs continuous changed over time was observed and the function analysis showed the potential role of miRNAs as therapeutic biomarkers. Additionally, the prediction model for KD showed a sensitivity of 78.8% and a specificity of 71.4%, respectively. This study used small RNA sequencing to identify miRNA biomarkers KD diagnosis based on a large sample size. Our findings shine a light on the understanding of molecular pathogenesis of KD and may improve the accuracy of KD diagnosis and prognosis in clinical.
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Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, Bonanomi E, D'Antiga L. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020; 395:1771-1778. [PMID: 32410760 PMCID: PMC7220177 DOI: 10.1016/s0140-6736(20)31103-x] [Citation(s) in RCA: 1580] [Impact Index Per Article: 395.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/03/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Bergamo province, which is extensively affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic, is a natural observatory of virus manifestations in the general population. In the past month we recorded an outbreak of Kawasaki disease; we aimed to evaluate incidence and features of patients with Kawasaki-like disease diagnosed during the SARS-CoV-2 epidemic. METHODS All patients diagnosed with a Kawasaki-like disease at our centre in the past 5 years were divided according to symptomatic presentation before (group 1) or after (group 2) the beginning of the SARS-CoV-2 epidemic. Kawasaki- like presentations were managed as Kawasaki disease according to the American Heart Association indications. Kawasaki disease shock syndrome (KDSS) was defined by presence of circulatory dysfunction, and macrophage activation syndrome (MAS) by the Paediatric Rheumatology International Trials Organisation criteria. Current or previous infection was sought by reverse-transcriptase quantitative PCR in nasopharyngeal and oropharyngeal swabs, and by serological qualitative test detecting SARS-CoV-2 IgM and IgG, respectively. FINDINGS Group 1 comprised 19 patients (seven boys, 12 girls; aged 3·0 years [SD 2·5]) diagnosed between Jan 1, 2015, and Feb 17, 2020. Group 2 included ten patients (seven boys, three girls; aged 7·5 years [SD 3·5]) diagnosed between Feb 18 and April 20, 2020; eight of ten were positive for IgG or IgM, or both. The two groups differed in disease incidence (group 1 vs group 2, 0·3 vs ten per month), mean age (3·0 vs 7·5 years), cardiac involvement (two of 19 vs six of ten), KDSS (zero of 19 vs five of ten), MAS (zero of 19 vs five of ten), and need for adjunctive steroid treatment (three of 19 vs eight of ten; all p<0·01). INTERPRETATION In the past month we found a 30-fold increased incidence of Kawasaki-like disease. Children diagnosed after the SARS-CoV-2 epidemic began showed evidence of immune response to the virus, were older, had a higher rate of cardiac involvement, and features of MAS. The SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease. A similar outbreak of Kawasaki-like disease is expected in countries involved in the SARS-CoV-2 epidemic. FUNDING None.
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Affiliation(s)
- Lucio Verdoni
- Paediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Angelo Mazza
- Paediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | - Laura Martelli
- Paediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Maurizio Ruggeri
- Paediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Matteo Ciuffreda
- Paediatric Cardiology, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Ezio Bonanomi
- Paediatric Intensive Care Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Lorenzo D'Antiga
- Paediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy.
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17
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Khan I, Li XA, Law B, U KI, Pan BQ, Lei C, Hsiao WLW. Correlation of gut microbial compositions to the development of Kawasaki disease vasculitis in children. Future Microbiol 2020; 15:591-600. [PMID: 32490694 DOI: 10.2217/fmb-2019-0301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Aim: Here, we hypothesize that dysbiotic gut microbiota might contribute to the development of Kawasaki disease (KD), a pediatric disease with unknown etiology. This is the second report on gut microbiota composition in KD patients. Materials & results: 16S amplicon sequencing was performed on fecal DNA samples and revealed predominance of bacterial pathogens, such as Fusobacterium, Neisseria, Shigella and Streptococcus, in the gut of KD patients, but absent or suppressed after immunoglobulin/antibiotics therapy. In addition, beneficial bacteria propagated after the therapy. Conclusion: We conclude that prevalence of Fusobacteria, Shigella and Streptococcus might contribute to KD pathogenesis.
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Affiliation(s)
- Imran Khan
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science & Technology, Macau SAR, China
| | - Xiao-ang Li
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science & Technology, Macau SAR, China
| | - Betty Law
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science & Technology, Macau SAR, China
| | - Ka In U
- Department of Pediatrics, Kiang Wu Hospital, Macau SAR, China
| | - Bao Quan Pan
- Department of Pediatrics, Kiang Wu Hospital, Macau SAR, China
| | - Cheng Lei
- Department of Pediatrics, Kiang Wu Hospital, Macau SAR, China
| | - WL Wendy Hsiao
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science & Technology, Macau SAR, China
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Shi R, Luo Y, Li S, Kong M, Liu X, Yu M, Wu J, Huang L, Yang Z. Single-nucleotide Polymorphism rs17860041 A/C in the Promoter of the PPIA Gene is Associated with Susceptibility to Kawasaki Disease in Chinese Children. Immunol Invest 2020; 50:230-242. [PMID: 32079425 DOI: 10.1080/08820139.2020.1727919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology. Cyclophilin A (CypA), also known as PPIA, has been identified to play a vital role in the pathogenesis of cardiovascular or inflammatory diseases. However, no studies have examined the relationship between single-nucleotide polymorphisms (SNPs) in the peptidylprolyl isomerase A (PPIA) and the development of KD and KD with or without coronary artery lesions (CALs). Objective: The present study was conducted to evaluate whether PPIA SNPs are associated with susceptibility to KD or CALs in KD. Methods: Three PPIA SNPs were genotyped in 101 KD patients and 105 healthy controls from a Chinese population. The allele and genotype frequencies were compared between the case and control groups, as well as in KD patients with and without CALs. Results: The data revealed a significant difference in the genotype and allele frequencies of rs17860041 A/C between KD patients and normal controls. Compared to the rs17860041 CC genotype, the AC genotype demonstrated a consistently beneficial roles in reducing the KD incidence. Furthermore, the allele frequency of C in the KD group was higher than that in the control group (P < .05). Haplotype analysis for PPIA polymorphisms (rs10951772 A/G, rs17860041 A/C, and rs4720485 A/T) also confirmed this association in KD patients and normal controls. Conclusion: A PPIA promoter SNP (rs17860041 A/C) confers susceptibility to KD in Chinese children and was identified as an important marker of KD in this study.
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Affiliation(s)
- Ruting Shi
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Yeping Luo
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Shentang Li
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Min Kong
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Xin Liu
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Meng Yu
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Jiping Wu
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
| | - Lihua Huang
- Center for Medical Experiments, the Third Xiangya Hospital, Central South University , Changsha, Hunan, China
| | - Zuocheng Yang
- Department of Pediatrics, Third Xiangya Hospital of Central South University , Changsha, Hunan, P.R. China
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Li J, Wang J, Su X, Jiang Z, Rong X, Gu X, Jia C, Zeng L, Zheng H, Gu X, Chu M. Association between the miRNA-149 rs2292832 T>C polymorphism and Kawasaki disease susceptibility in a southern Chinese population. J Clin Lab Anal 2019; 34:e23125. [PMID: 31785027 PMCID: PMC7171309 DOI: 10.1002/jcla.23125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/02/2019] [Accepted: 11/05/2019] [Indexed: 12/15/2022] Open
Abstract
Background Kawasaki disease (KD), which is characterized by vasculitis, is prone to occur in patients under 5 years of age, has an ambiguous etiology, and displays coronary artery lesions as the chief complication. Previous studies have linked miRNA‐149 to cancers, and rs2292832 T>C is related to allergic diseases and inflammatory bowel disease, which both show immune system disorders and coronary artery disease. Therefore, we performed a study concentrating on the association between the miRNA‐149 rs2292832 T>C polymorphism and KD susceptibility. Methods The subjects enrolled were 532 children with KD and 623 controls. We used TaqMan real‐time PCR to obtain the genotypes of the rs2292832 T>C polymorphism. Results Ultimately, no significant association was found between the miRNA‐149 rs2292832 T>C polymorphism and KD susceptibility, even in stratification analysis. Conclusion Our results indicated that in southern Chinese patients, the miRNA‐149 rs2292832 T>C polymorphism did not affect KD susceptibility, which needs to be further confirmed.
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Affiliation(s)
- Jiawen Li
- Children's Heart CenterThe Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical UniversityWenzhouChina
| | - Jinxin Wang
- Children's Heart CenterThe Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical UniversityWenzhouChina
| | - Xiaoping Su
- Children's Heart CenterThe Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical UniversityWenzhouChina
| | - Zhiyong Jiang
- Department of Blood Transfusion and Clinical LabGuangzhou Institute of PediatricsGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouChina
| | - Xing Rong
- Children's Heart CenterThe Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical UniversityWenzhouChina
| | - Xueping Gu
- Department of Blood Transfusion and Clinical LabGuangzhou Institute of PediatricsGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouChina
| | - Chang Jia
- Children's Heart CenterThe Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical UniversityWenzhouChina
| | - Lanlan Zeng
- Department of Clinical LabGuangzhou Institute of PediatricsGuangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina
| | - Hao Zheng
- Department of Clinical LabGuangzhou Institute of PediatricsGuangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina
| | - Xiaoqiong Gu
- Department of Blood TransfusionClinical Biological Resource Bank and Clinical LabGuangzhou Institute of PediatricsGuangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouChina
| | - Maoping Chu
- Children's Heart CenterThe Second Affiliated Hospital and Yuying Children's HospitalInstitute of Cardiovascular Development and Translational MedicineWenzhou Medical UniversityWenzhouChina
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Zhu L, Lao L, Huang Y, Lin X, Liu J. A child with Kawasaki disease successfully treated with Chinese herbal medicine: A case report with 12-month follow up. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sugahara-Tobinai A, Inui M, Metoki T, Watanabe Y, Onuma R, Takai T, Kumaki S. Augmented ILT3/LILRB4 Expression of Peripheral Blood Antibody Secreting Cells in the Acute Phase of Kawasaki Disease. Pediatr Infect Dis J 2019; 38:431-438. [PMID: 30882741 DOI: 10.1097/inf.0000000000002259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Kawasaki disease (KD) is an acute, systemic vasculitis syndrome that occurs in children. The clinical symptoms and epidemiologic features of KD strongly suggest that KD is triggered by unidentified infectious agents in genetically predisposed patients. In addition, a number of studies have described the role of B cells in the development of KD. To obtain a mechanistic insight into the humoral immune response of B-lineage cells in KD patients, we examined peripheral blood antibody secreting cells (ASCs) and inhibitory immunoreceptors, immunoglobulin-like transcript (ILT)/leukocyte immunoglobulin-like receptor (LILR), on each B cell subpopulation. METHODS Eighteen Japanese KD patients and thirteen healthy control subjects were recruited for this study. Their peripheral blood mononuclear cells were examined by flow cytometry for the number of CD19 B cells, the size of each B cell subset and the expression of the inhibitory isoforms of ILT/LILR on the B cell subset. RESULTS The frequency of CD19CD27 ASCs was significantly increased in the acute phase of KD and reduced after high-dose intravenous immunoglobulin (IVIG) treatment. Interestingly, while ILT2/LILRB1 expression was ubiquitously observed on every B cell/ASCs subset and the level was not significantly different after IVIG, ILT3/LILRB4 (B4) was uniquely expressed on only ASCs, and its expression was significantly decreased after IVIG. CONCLUSIONS In the acute phase of KD, the frequency of ASCs is high with augmented B4 expression, whereas it is lower with decreased B4 expression after IVIG. Further studies of B4 expression on ASCs in autoimmune and infectious diseases will be needed to confirm the significance of our findings.
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Affiliation(s)
- Akiko Sugahara-Tobinai
- From the Department of Experimental Immunology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Masanori Inui
- From the Department of Experimental Immunology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Takaya Metoki
- Department of Pediatrics, Sendai Medical Center, Sendai, Japan
| | - Yohei Watanabe
- Department of Pediatrics, Sendai Medical Center, Sendai, Japan
| | - Ryoichi Onuma
- Department of Pediatrics, Sendai Medical Center, Sendai, Japan
| | - Toshiyuki Takai
- From the Department of Experimental Immunology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Satoru Kumaki
- Department of Pediatrics, Sendai Medical Center, Sendai, Japan
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Wu J, Zhou Q, Niu Y, Chen J, Zhu Y, Ye S, Xi Y, Wang F, Qiu H, Bu S. Aberrant expression of serum circANRIL and hsa_circ_0123996 in children with Kawasaki disease. J Clin Lab Anal 2019; 33:e22874. [PMID: 30843267 PMCID: PMC6595332 DOI: 10.1002/jcla.22874] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/27/2018] [Accepted: 02/10/2019] [Indexed: 12/19/2022] Open
Abstract
Background Kawasaki disease is a childhood systemic vasculitis that causes coronary artery abnormalities. The etiology remains unknown and there are no specific diagnostic tests. Circular non‐coding RNAs are a special class of endogenous RNAs that display some characteristics of an ideal biomarker. However, few studies have examined the expression of circRNAs in the serum of Kawasaki disease (KD) patients. The aim of this study was to identify circRNAs in the serum that can serve as potential biomarkers for KD diagnosis. Methods The cases were children diagnosed with KD (n = 56). The controls comprised healthy children (n = 56). Blood was collected from the patients before and after intravenous immunoglobulin therapy, and from the healthy controls. Levels of circANRIL and hsa_circ_0123996 in the serum were measured by quantitative reverse transcription PCR. Then, the potential relationship between serum circRNA levels and patients’ biochemical parameter levels was investigated. Receiver operating characteristic curves were constructed for evaluating the diagnostic value of these circRNAs. Results The serum levels of circANRIL were lower in patients with KD before therapy than in the controls, but became higher in the patients after therapy than before therapy. The serum levels of hsa_circ_0123996 were higher in patients with KD before therapy than in healthy controls. Conclusion Our study indicated that the circANRIL and hsa_circ_0123996 levels in the serum of patients with KD were significantly different from those in healthy individuals. circANRIL and hsa_circ_0123996 may become potential biomarkers for early KD diagnosis.
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Affiliation(s)
- Junhua Wu
- The Ningbo Women and Children's Hospital, Ningbo, China
| | - Qianqin Zhou
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Yadan Niu
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Jiayi Chen
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Yingchao Zhu
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Shazhou Ye
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Yang Xi
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Fuyan Wang
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
| | - Haiyan Qiu
- The Ningbo Women and Children's Hospital, Ningbo, China
| | - Shizhong Bu
- Diabetes Research Center, School of Medicine, Ningbo University, Ningbo, China
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de La Harpe M, di Bernardo S, Hofer M, Sekarski N. Thirty Years of Kawasaki Disease: A Single-Center Study at the University Hospital of Lausanne. Front Pediatr 2019; 7:11. [PMID: 30761279 PMCID: PMC6363689 DOI: 10.3389/fped.2019.00011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/14/2019] [Indexed: 12/19/2022] Open
Abstract
Kawasaki disease is an acute vasculitis with a particular involvement of the coronary arteries. Coronary artery aneurysms develop in 20% of untreated children. It has been shown that early treatment with intravenous immunoglobulins and aspirin decreases this risk to 5%, but the medium to long term prognosis of children with Kawasaki disease is still unclear. To determine the outcome of the disease and risk factors for poor evolution, we reviewed retrospectively the medical records of all patients with a diagnosis of Kawasaki disease at our Institution between 1981 and 2014. Among the 207 patients included in the study, 96 patients had coronary diameter anomalies (46.4%) at diagnosis and children with atypical ages for Kawasaki disease (<1 year or >10 year of age) were more often affected with aneurysms or dilatations. Eighty-four of them had complete regression of coronary aneurysms during the follow-up (87.5%) Absence of immunoglobulins in the acute phase was associated with less regression rate (57.1 vs. 92.2%), and boys had greater z-scores at last echocardiography, statistically significant for the left anterior descending artery. We found rare complications after the acute phase documented in our patient charts (only 3.8%). Recurrence of the disease occurred in 5 children (2.4%) and myocardial ischemia in 3 patients (1.4%), all with initial coronary aneurysm. Conclusion: Medium to long term prognosis after Kawasaki disease is excellent. Boys, patients not treated with immunoglobulins or outside the usual age range are more at risk for an unfavorable outcome.
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Affiliation(s)
- Marion de La Harpe
- Pediatric Cardiology Unit, University of Lausanne, Lausanne, Switzerland
| | - Stefano di Bernardo
- Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Michaël Hofer
- Pediatric Rheumatology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Nicole Sekarski
- Pediatric Cardiology Unit, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
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24
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Wang X, Ding YY, Chen Y, Xu QQ, Qian GH, Qian WG, Cao L, Zhou WP, Hou M, Lv HT. MiR-223-3p Alleviates Vascular Endothelial Injury by Targeting IL6ST in Kawasaki Disease. Front Pediatr 2019; 7:288. [PMID: 31396494 PMCID: PMC6667785 DOI: 10.3389/fped.2019.00288] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/26/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Kawasaki disease (KD) is a self-limiting illness with acute systematic vascular inflammation. It causes pathological changes in mostly medium and small-sized arteries, especially the arteria coronaria, which adds the risk of developing coronary heart disease in adults. Materials and methods: We detected the miR-223-3p expression in 30 KD patients combined with 12 normal controls using miRNA microarrays and RT-PCR. A KD mouse model was constructed using Candida albicans water insoluble substance (CAWS). We also checked the miR-223-3p's expression using qRT-PCR. The Luciferase reporting system was implemented to validate the correlation between miR-223-3p and Interleukin-6 receptor subunit beta (IL-6ST). TNF-α was used to stimulate human coronary artery endothelial cells (HCAECs), and miR-223-3p activator or inhibitor and KD serum were used to treat HCAECs. A Western blotting automatic quantitative analysis protein imprinting system was used to test the expression of signal transducer and the activator of transcription 3 (STAT3), phosphorylated-signal transducer and the activator of transcription 3 (pSTAT3) and NF-κB p65. Results: Clinical trials found that miR-223-3p expressions were markedly different (more than 2-fold) between the acute KD group and the control group. E-selectin and intercellular cell adhesion molecule-1 (ICAM-1) levels were also significantly higher (about 2-fold) in KD especially with coronary artery lesions. MiR-223-3p could alleviate vascular endothelial damage in KD mice, and IL-6 (Interleukin-6), E-selectin and ICAM-1 were simultaneously negative. The values of IL-6, E-selectin, and ICAM-1 mRNA expressions decreased, while the value of IL-6ST was increased between the agonist treated mice and KD mice. The RT-qPCR consequences displayed that miR-223-3p explored the highest expression on the third day in both the KD mice as well as the agonist group. MiR-223-3p can directly combine with IL-6ST 3' untranslatable regions (UTR) and held back the IL-6's expression. Overexpression of miR-223 down regulated IL6ST expression and decreased the expression of p-STAT3 and NF-κB p65, while the miR-223 inhibitor could reverse the above process. Conclusion: MiR-223-3p is an important regulatory factor of vascular endothelial damage in KD and could possibly become a potential target of KD treatment in the future.
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Affiliation(s)
- Xiang Wang
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China.,Department of Pediatrics, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Yue Yue Ding
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Ye Chen
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Qiu Qin Xu
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Guang Hui Qian
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China.,Pediatric Research Institute of Soochow University, Suzhou, China
| | - Wei Guo Qian
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Lei Cao
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Wan Ping Zhou
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Miao Hou
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
| | - Hai Tao Lv
- Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China
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25
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Terry J, Brown K, Hiebert J, Al-Rawahi GN, Moxham JP, Krajden M, Jassem AN, Tucker L. Measles Lymphadenopathy in a Child With PFAPA Syndrome. Pediatr Dev Pathol 2018; 21:497-501. [PMID: 28882091 DOI: 10.1177/1093526617727970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a common cause of periodic fever in children. The pathogenesis of PFAPA is unknown but likely involves immune system dysregulation and may be initiated by an environmental trigger. Tonsillectomy resolves or improves symptoms in some patients, but the reason for this is unknown; moreover, specific abnormalities in tonsillectomy specimens from PFAPA patients have not been described. Here, we report measles virus in tonsil from a child with PFAPA. Measles-type viral cytopathic effect was discovered on histological examination of tonsillar tissue after therapeutic tonsillectomy for PFAPA. Molecular testing showed the left tonsil was positive for measles RNA by reverse transcription polymerase chain reaction (RT-PCR) while the right tonsil was inconclusive (weakly positive). Real-time RT-PCR specific for measles vaccine strain RNA (genotype A) was weakly reactive in the left tonsil tissue when tested in 3 independent replicates, but this result could not be confirmed with conventional genotyping by sequencing. The relationship and clinical significance between measles virus and PFAPA in this case is unclear but may be related to PFAPA-associated immune dysregulation. Additional investigation of measles virus in PFAPA patients would be helpful in further exploring this potential association.
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Affiliation(s)
- Jefferson Terry
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Kelly Brown
- 2 Division of Pediatric Rheumatology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Joanne Hiebert
- 3 National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ghada N Al-Rawahi
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - J Paul Moxham
- 4 Department of Surgery, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Mel Krajden
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Agatha N Jassem
- 1 Department of Pathology and Laboratory Medicine, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Lori Tucker
- 2 Division of Pediatric Rheumatology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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Abstract
OBJECTIVE Vitamin D is a group of fat-soluble molecules that are structurally similar to steroids. Emerging data have led to the hypothesis that Vitamin D plays a role in the regulation of many physiological processes beyond calcium and phosphorus homeostasis. With this review, we aimed to summarize the changes in Vitamin D levels in children with cardiovascular diseases based on the literature. In addition, we also reviewed the potential mechanisms underlying cardiovascular diseases associated with Vitamin D deficiency or insufficiency. DATA SOURCES The articles in English were searched from PubMed (1968-2016) and EMBASE (1991-2016), with the keywords of "Vitamin D AND cardiovascular diseases" and "Vitamin D AND children." STUDY SELECTION Original articles and critical reviews about Vitamin D and cardiovascular risk in children were selected for review. Researches focused on adults were excluded. RESULTS Studies have shown that several pediatric cardiovascular diseases may be associated with Vitamin D deficiency or insufficiency, including hypertension, orthostatic intolerance, and Kawasaki disease. CONCLUSIONS Vitamin D may play a role in the regulation of the cardiovascular system. Further investigation would hopefully disclose the usefulness of Vitamin D as a biomarker for cardiovascular diseases in children.
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Affiliation(s)
- Wen-Rui Xu
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
| | - Hong-Fang Jin
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
| | - Jun-Bao Du
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
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27
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Association of Thrombomodulin Gene C1418T Polymorphism with Susceptibility to Kawasaki Disease in Chinese Children. DISEASE MARKERS 2018; 2018:1064380. [PMID: 30008974 PMCID: PMC6020540 DOI: 10.1155/2018/1064380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 05/03/2018] [Indexed: 12/17/2022]
Abstract
Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects children and can result in coronary artery lesions (CALs). Thrombomodulin (TM) is a critical cofactor in the protein C anticoagulant system. The TM C1418T (rs1042579) polymorphism is associated with a high risk of cardiac-cerebral vascular diseases. But the association of the TM C1418T polymorphism with susceptibility to KD, CAL formation, and intravenous immunoglobulin (IVIG) resistance is still unclear. In our study, we examined the TM C1418T polymorphism in 122 children with KD and 126 healthy children and revealed the correlation between the TM C1418T polymorphism and KD, CAL formation, and IVIG resistance.
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28
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Dos Santos Domingues A, Selleski N, Uenishi RH, Medeiros Ribeiro de Magalhães C, Gandolfi L, Pratesi CB. The possible link between coeliac and Kawasaki diseases in Brazil: a cross-sectional study. BMJ Open 2018; 8:e018803. [PMID: 29444780 PMCID: PMC5829591 DOI: 10.1136/bmjopen-2017-018803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Kawasaki disease (KD) is a self-limited acute systemic vasculitis of unknown aetiology that predominantly affects infants and young children eventually associated with immunological abnormalities. Coeliac disease (CD) is an inflammatory autoimmune disease characterised by a permanent gluten intolerance, which affects genetically susceptible individuals of any age group, and can cause intestinal and systemic symptoms. Association of CD with KD has been previously described in a single study that disclosed a surprisingly high prevalence of CD in children with a history of KD. OBJECTIVE To confirm the existence of a higher prevalence of CD among individuals with a history of KD, which would turn the screening for CD in patients with history of KD highly advisable. SETTING Children with history of KD, diagnosed and followed at the Rheumatology Clinic of the Children's Hospital of Brasilia (Brasilia, Brazil). PARTICIPANTS This study included 110 children with history of KD and a control group composed of 110 presumably healthy children. INTERVENTIONS Participants underwent anti-transglutaminase and anti-endomysial antibodies tests and genetic typing for the presence of CD predisposing alleles (HLA-DQ2 and DQ8). Jejunal biopsy was performed when necessary, according the European Society of Paediatric Gastroenterology, Hepatology and Nutrition guidelines. RESULTS Diagnosis of CD was confirmed in one (0.91%) patient with KD by positive serological tests, presence of predisposing alleles and CD typical lesions on duodenal biopsy. All serological tests were negative among the controls. The prevalence of CD predisposing alleles among patients with KD was 29.09%, similar to the prevalence found among controls, 33.64%. CONCLUSION The detected CD prevalence (0.91%) does not confirm the existence of an association between KD and CD since this prevalence is similar to that found in the general population (≃1%).
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Affiliation(s)
| | - Nicole Selleski
- Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasilia, Brazil
- Post-graduate Program in Health Sciences, School of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Rosa Harumi Uenishi
- Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasilia, Brazil
- Post-graduate Program in Health Sciences, School of Health Sciences, University of Brasilia, Brasilia, Brazil
| | | | - Lenora Gandolfi
- Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasilia, Brazil
- Post-graduate Program in Health Sciences, School of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Claudia B Pratesi
- Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasilia, Brazil
- Post-graduate Program in Health Sciences, School of Health Sciences, University of Brasilia, Brasilia, Brazil
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29
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[Sudden death of a young man as late sequelae complicating a pediatric disease: About a case]. Ann Pathol 2017; 37:188-192. [PMID: 28325512 DOI: 10.1016/j.annpat.2017.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 01/18/2016] [Accepted: 01/13/2017] [Indexed: 11/21/2022]
Abstract
In France, sudden death is responsible every year for 40,000 deaths. The most frequent etiology is cardiac disease. Atheromatous-related pathology is the most common etiology beyond 35, but cardiomyopathies and channelopathies are responsible for a significant number of deaths in young adults. Some acquired disorders can also cause sudden cardiac death. We report the case of a 17-year-old man who died suddenly after sport. Autopsy and pathological study found multiple giant coronary aneurysms. Thrombosis and fibrous scar of myocardial ischemic events were observed. These lesions were in favor of late sequelae of Kawasaki disease. Kawasaki disease is a rare but not exceptional cause of sudden cardiac death in young adults. In the lack of known clinical history, some aspects, even not specific, should evoke this diagnosis. Even in front of apparent good clinical tolerance, these sequelae require appropriate follow-up because of a significant risk of sudden death.
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30
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Phuong LK, Bonetto C, Buttery J, Pernus YB, Chandler R, Felicetti P, Goldenthal KL, Kucuku M, Monaco G, Pahud B, Shulman ST, Top KA, Trotta F, Ulloa-Gutierrez R, Varricchio F, de Ferranti S, Newburger JW, Dahdah N, Singh S, Bonhoeffer J, Burgner D. Kawasaki disease and immunisation: A systematic review. Vaccine 2017; 35:1770-1779. [PMID: 28259442 DOI: 10.1016/j.vaccine.2016.09.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 02/09/2023]
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Serum miR-92a-3p as a New Potential Biomarker for Diagnosis of Kawasaki Disease with Coronary Artery Lesions. J Cardiovasc Transl Res 2016; 10:1-8. [PMID: 27981487 DOI: 10.1007/s12265-016-9717-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/28/2016] [Indexed: 12/25/2022]
Abstract
Recent studies have suggested that serum microRNAs (miRNAs) are novel biomarkers for many cardiovascular diseases, but their role in Kawasaki disease (KD) is still unclear. We demonstrated that serum miR-92a-3p levels were significantly higher in children with KD compared with children with fever and controls (both P < 0.05). When the disease recovered, miR-92a-3p levels returned to those of controls. Clinical and pathological data showed that high levels of miR-92a-3p were significantly associated with coronary artery lesions (CALs). Analysis of the receiver operating characteristic (ROC) curve showed that serum miR-92a-3p had a sensitivity of 81.8% and a specificity of 66.7% for distinguishing KD with CALs from KD without CALs. The area under the curve was 0.816 (P < 0.05, 95% CI 0.669-0.962). Therefore, the miRNA miR-92a-3p may be used as a potential biomarker for diagnosis of KD and KD with coronary artery lesions.
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32
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Agarwal S, Agrawal DK. Kawasaki disease: etiopathogenesis and novel treatment strategies. Expert Rev Clin Immunol 2016; 13:247-258. [PMID: 27590181 DOI: 10.1080/1744666x.2017.1232165] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Kawasaki disease is an acute febrile systemic vasculitis that predominantly occurs in children below five years of age. Its etiopathogenesis is still not clear, but it is thought to be a complex interplay of genetic factors, infections and immunity. Areas covered: This review article discusses in detail Kawasaki disease, with particular emphasis on the recent updates on its pathogenesis and upcoming alternate treatment options. Though self-limiting in many cases, it can lead to severe complications like coronary artery aneurysms and thrombo-embolic occlusions, and hence requires early diagnosis and urgent attention to avoid them. Intravenous immunoglobulin (IVIG) with or without aspirin has remained the sole treatment option for these cases, but 10-15% cases develop resistance to this treatment. Expert commentary: There is a need to develop additional treatment strategies for children with Kawasaki disease. Targeting different steps of pathogenesis could provide us with alternate therapeutic options.
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Affiliation(s)
- Shreya Agarwal
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
| | - Devendra K Agrawal
- a Department of Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA
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33
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Abstract
Kawasaki disease is an acute, self-limited vasculitis of childhood and has become the leading cause of acquired pediatric heart disease in the USA. Prompt treatment is essential in reducing cardiac-related morbidity and mortality. The underlying etiology remains unknown. The disease itself may be the characteristic manifestation of a common pathway of immune-mediated vascular inflammation in susceptible hosts. The characteristic clinical features of fever for at least 5 days with bilateral nonpurulent conjunctivitis, rash, changes in lips and oral cavity, changes in peripheral extremities, and cervical lymphadenopathy remain the mainstay of diagnosis. Supplementary laboratory criteria can aid in the diagnosis, particularly in cases of incomplete clinical presentation. Diagnosis of Kawasaki disease can be challenging as the clinical presentation can be mistaken for a variety of other pediatric illnesses. Standard of care consists of intravenous immune globulin and aspirin. Corticosteroids, infliximab, and cyclosporine A have been used as adjunct therapy for Kawasaki disease refractory to initial treatment. There is ongoing research into the use of these agents in the initial therapy of Kawasaki disease.
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Affiliation(s)
- Frank H. Zhu
- Division of Infectious Diseases, Children’s Hospital of Michigan, 3901 Beaubien Street, Detroit, MI 48201 USA
- Department of Pediatrics, Wayne State University, School of Medicine, Detroit, MI 48201 USA
| | - Jocelyn Y. Ang
- Division of Infectious Diseases, Children’s Hospital of Michigan, 3901 Beaubien Street, Detroit, MI 48201 USA
- Department of Pediatrics, Wayne State University, School of Medicine, Detroit, MI 48201 USA
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34
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Burnham CAD, McAdam AJ. Your Viral Past: A Comprehensive Method for Serological Profiling to Explore the Human Virome. Clin Chem 2016; 62:426-7. [PMID: 26769753 DOI: 10.1373/clinchem.2015.245027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 11/23/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Carey-Ann D Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO;
| | - Alexander J McAdam
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA
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35
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Mansoor S, Sabella C, Auron M, Erenberg F, Zeft A. Weighing Evidence and Art: A Challenging Case of Early-Onset Atypical Kawasaki Disease. Hosp Pediatr 2015; 5:591-6. [PMID: 26526806 DOI: 10.1542/hpeds.2014-0228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - Moises Auron
- Departments of Pediatrics, Pediatric Hospital Medicine
| | | | - Andrew Zeft
- Departments of Pediatrics, Pediatric Rheumatology, Cleveland Clinic Children's, Cleveland, Ohio
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36
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Fraison JB, Sève P, Dauphin C, Mahr A, Gomard-Mennesson E, Varron L, Pugnet G, Landron C, Roblot P, Oziol E, Chalhoub G, Galempoix JM, Humbert S, Humbert P, Sbidian E, Grange F, Bayrou O, Cathebras P, Morlat P, Epaulard O, Pavese P, Huong DLT, Zoulim A, Stankovic K, Bachelez H, Smail A, Bachmeyer C, Granel B, Serratrice J, Brinchault G, Mekinian A, Costedoat-Chalumeau N, Bourgarit-Durand A, Puéchal X, Guillevin L, Piram M, Koné-Paut I, Fain O. Kawasaki disease in adults: Observations in France and literature review. Autoimmun Rev 2015; 15:242-9. [PMID: 26631821 DOI: 10.1016/j.autrev.2015.11.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 11/20/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Kawasaki disease (KD) is a vasculitis that mostly occurs in young children and rarely in adults. We analyzed the characteristics of adult-onset KD (AKD) in France. METHODS We collected retrospective and prospective data for patients with a diagnosis of KD occurring after the age of 18 years. Cases were obtained via various French medical networks and identified from the international literature. RESULTS We included 43 patients of AKD at 26 institution from 1992 to 2015, with mean (SD) age 30 (11) years (range 18-68) and sex ratio (M/F) 1.2; 34 patients met the American Heart Association criteria and 9 were incomplete AKD. The median time to diagnosis was 13 days (interquartile range 8-21). The main symptoms were fever (100%), exanthema (98%), changes in the extremities (91%), conjunctivitis (77%), oral cavity changes (89%), cervical adenitis (55%) and cardiac abnormalities (45%). Overall, 35% of patients showed large-vessel vasculitis: coronary vasculitis (26%) and coronary aneurysm (19%). Treatment was mostly intravenous immunoglobulins (79%) and aspirin (81%). Four patients showed myocardial infarction due to coronary vasculitis, but none were treated with IVIg because of late diagnosis. After a median follow-up of 5 months (range 1-117), persistent aneurysm was noted in 9% of cases. Damage was significantly lower with early treatment than late or no treatment (p=0.01). CONCLUSION Given the high frequency of cardiac involvement and complications in this series of AKD, diagnosis and treatment should not be delayed, and early IVIg treatment seems to improve the outcome.
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Affiliation(s)
- Jean-Baptiste Fraison
- Service de Médecine Interne, Hôpital Saint Louis, AP HP, Université Diderot, France.
| | - Pascal Sève
- Service de Médecine Interne, Hôpital de la Croix Rousse, Centre Hospitalier Universitaire de Lyon, Université de Lyon, France
| | - Claire Dauphin
- Service de Cardiologie, Hôpital Gabriel Montpied, Université de Clermont-Ferrand, France
| | - Alfred Mahr
- Service de Médecine Interne, Hôpital Saint Louis, AP HP, Université Diderot, France
| | | | - Loig Varron
- Service de Médecine Interne, Centre Hospitalier de Montélimar, France
| | - Gregory Pugnet
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, France
| | - Cédric Landron
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Poitiers, France
| | - Pascal Roblot
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Poitiers, France
| | - Eric Oziol
- Service de Médecine Interne, Centre Hospitalier de Béziers, France
| | - Gihane Chalhoub
- Service de Médecine Interne, Centre Hospitalier de Metz-Thionville, France
| | - Jean-Marc Galempoix
- Service de Médecine Interne, Centre Hospitalier de Charleville-Mézières, France
| | - Sébastien Humbert
- Service de Médecine Interne, Centre Hospitalier Universitaire de Besançon, France
| | - Philippe Humbert
- Service de Dermatologie, Centre Hospitalier Universitaire de Besançon, University of Franche-Comté, INSERM UMR1098, SFR FED 4234 IBCT, Besançon, France
| | - Emilie Sbidian
- Service de Dermatologie, Hôpital Henri Mondor, AP HP, Université Paris Est, France
| | - Florent Grange
- Service de Dermatologie, Centre Hospitalier Universitaire de Reims, France
| | - Olivier Bayrou
- Service de Dermatologie, Hôpital Tenon, AP HP, Université Pierre et Marie Curie, France
| | - Pascal Cathebras
- Service de Médecine Interne, Centre Hospitalier Universitaire de St Etienne, France
| | - Philippe Morlat
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Bordeaux, France
| | - Olivier Epaulard
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Grenoble, France
| | - Patricia Pavese
- Service de Maladies Infectieuses, Centre Hospitalier Universitaire de Grenoble, France
| | - Du Le Thi Huong
- Service de Médecine Interne 2, Hôpital La Pitié-Salpétrière, AP HP, Université Pierre et Marie Curie, France
| | - Abdelkader Zoulim
- Service de Médecine Interne, Centre Hospitalier Universitaire de Caen, France
| | - Katia Stankovic
- Service de Médecine Interne, Hôpital Tenon, AP HP, Université Pierre et Marie Curie, France
| | - Hervé Bachelez
- Service de Dermatologie, Hôpital Saint Louis, AP HP, Université Diderot, France
| | - Amar Smail
- Service de Médecine Interne, Centre Hospitalier Universitaire d'Amiens, France
| | - C Bachmeyer
- Service de Médecine Interne, Centre Hospitalier de Creil, France
| | | | | | | | - Arsène Mekinian
- Service de Médecine Interne, DHUi2B, Hôpital Saint Antoine, AP HP, Université Pierre et Marie Curie, France
| | - Nathalie Costedoat-Chalumeau
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques et Autoimmunes Rares, AP HP, Université Paris Descartes, France
| | - Anne Bourgarit-Durand
- Service de Médecine Interne, Hôpital Jean Verdier, AP HP, Université Leonard de Vinci, France
| | - Xavier Puéchal
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques et Autoimmunes Rares, AP HP, Université Paris Descartes, France
| | - Loïc Guillevin
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence Maladies Systémiques et Autoimmunes Rares, AP HP, Université Paris Descartes, France
| | - Maryam Piram
- Service de Rhumatologie Pédiatrique, Centre de Référence des Maladies Auto-Inflammatoires de l'enfant, Hôpital Bicêtre, AP HP, Université Paris Sud, France
| | - Isabelle Koné-Paut
- Service de Rhumatologie Pédiatrique, Centre de Référence des Maladies Auto-Inflammatoires de l'enfant, Hôpital Bicêtre, AP HP, Université Paris Sud, France
| | - Olivier Fain
- Service de Médecine Interne, DHUi2B, Hôpital Saint Antoine, AP HP, Université Pierre et Marie Curie, France
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Parthasarathy P, Agarwal A, Chawla K, Tofighi T, Mondal TK. Upcoming biomarkers for the diagnosis of Kawasaki disease: A review. Clin Biochem 2015; 48:1188-94. [DOI: 10.1016/j.clinbiochem.2015.02.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 12/31/2022]
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Bioresorbable Vascular Scaffold Implantation for Successful Treatment of a Symptomatic Coronary Lesion in a 17-Year-Old Boy After Kawasaki Disease. Pediatr Cardiol 2015; 36:1539-41. [PMID: 26063383 DOI: 10.1007/s00246-015-1215-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 05/28/2015] [Indexed: 11/26/2022]
Abstract
Coronary stenting is considered a promising treatment option for patients with coronary artery lesions caused by Kawasaki disease (KD). Here, we report the case of an adolescent with KD who successfully underwent implantation of a fully bioresorbable vascular scaffold (BVS) in a Kawasaki-related, highly obstructed coronary artery. Control coronary angiography 6 months later showed a remaining good result without restenosis or development of aneurysm. Cardial MRI and clinical follow-up revealed stable results at 6 and 18 months without any signs of ischemia. To our knowledge, this is the first report of a successful implantation of a fully bioresorbable vascular scaffold in a young adult with the history of KD. The case illustrates the feasibility and safety of BVS implantation for the treatment of KD. It remains to be confirmed by further studies, if this approach by this novel material might be a therapeutic alternative to coronary bypass grafting or other coronary interventions.
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Abstract
The term "systemic vasculitis" encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults. In 2006, the European League Against Rheumatism (EULAR) and the Pediatric Rheumatology European Society (PReS) proposed a classification system for childhood vasculitis adopting the system devised in the Chapel Hill Consensus Conference in 1993, which categorizes vasculitides according to the predominant size of the involved blood vessels into small, medium and large vessel diseases. Currently, medical imaging has a pivotal role in the diagnosis of vasculitis given recent developments in the imaging of blood vessels. For example, early diagnosis of coronary artery aneurysms, a serious complication of Kawasaki disease, is now possible by magnetic resonance imaging (MRI) of the heart and multidetector computed tomography (MDCT); positron emission tomography/CT (PET/CT) helps to assess active vascular inflammation in Takayasu arteritis. Our review offers a unique approach using the integration of the proposed classification criteria for common systemic childhood vasculitides with their most frequent imaging findings, along with differential diagnoses and an algorithm for diagnosis based on common findings. It should help radiologists and clinicians reach an early diagnosis, therefore facilitating the ultimate goal of proper management of affected children.
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Affiliation(s)
- Magdy Soliman
- Department of Medical Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G1X8, Canada
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Jang GY, Kang IS, Choi JY, Bae EJ, Kim YH, Kim SH, Ma JS. Nationwide survey of coronary aneurysms with diameter >6 mm in Kawasaki disease in Korea. Pediatr Int 2015; 57:367-72. [PMID: 25406095 DOI: 10.1111/ped.12536] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 08/29/2014] [Accepted: 11/05/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND We investigated the course of coronary aneurysm with diameter > 6 mm in Kawasaki disease (KD), as well as related therapeutic trends and prognosis in Korea. METHODS A nationwide questionnaire survey was carried out in 77 hospitals, to investigate, retrospectively, patients with KD who had coronary aneurysms with a diameter > 6 mm between 1990 and 2011. RESULTS The median age of onset was 3 years (range, 2 months-16 years) in a total of 239 patients. During the acute stage of KD, most patients received i.v. immunoglobulins and aspirin. In addition, 27 patients received steroid therapy. In the current study, the mean coronary aneurysm size was 8.7 ± 3.2 mm (range, 6-21 mm). Twenty-two patients underwent interventional catheterization. Procedures included percutaneous transluminal coronary balloon angioplasty (n = 10), stent placement (n = 9), and percutaneous transluminal coronary rotational ablation (n = 3). Fourteen patients underwent coronary artery bypass graft surgery. Of the 239 patients who had coronary aneurysms with diameter > 6 mm, 13 (5.4%) presented with findings suggestive of myocardial infarction. Five patients died during the follow-up period. CONCLUSIONS Severe stenosis or occlusion of the coronary artery may occur in some patients who develop coronary aneurysms with diameter > 6 mm; early management such as coronary interventions or surgery should be considered in such cases.
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Affiliation(s)
- Gi Young Jang
- Department of Pediatrics, Korea University Hospital, Ansan, Korea
| | - I-seok Kang
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Young Choi
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Young-Hwue Kim
- Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Ho Kim
- Department of Pediatrics, Sejong Cardiovascular Center, Sejong General Hospital, Bucheon, Korea
| | - Jae Sook Ma
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
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Drago F, Javor S, Ciccarese G, Cozzani E, Parodi A. A Case of Complete Adult-Onset Kawasaki Disease: A Review of Pathogenesis and Classification. Dermatology 2015; 231:5-8. [DOI: 10.1159/000381911] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 03/26/2015] [Indexed: 11/19/2022] Open
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Abstract
This Review summarizes recent advances in understanding of the pathologic processes and pathophysiologic mechanisms leading to coronary arteritis in Kawasaki disease, and describes current approaches to its treatment. Kawasaki disease is the most common cause of acquired heart disease among children in developed countries, in whom the resulting coronary artery abnormalities can cause myocardial ischaemia, infarction and even death. Epidemiologic data strongly suggest an infectious aetiology, although the causative agent has yet to be identified. Genetic factors also increase susceptibility to Kawasaki disease, as indicated by its strikingly high incidence rate in children of Asian ethnicity and by an increased incidence in first-degree family members. The treatment of Kawasaki disease is based on timely administration of intravenous immunoglobulin and aspirin. However, the management of patients who do not respond to this standard therapy remains challenging; although several options are available, comparative data on which to base treatment decisions are scarce. The added value of adjunctive therapy with corticosteroids in patients at particularly high risk of coronary complications has been demonstrated in Japanese populations, but identification of high-risk patients has proven to be difficult in ethnically diverse populations.
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Edwards M, Tinoco-Mendoza G, Tovmassian D, Ling T, Teh JR, Ong C, Mudgil P, Whitehall J. Kawasaki disease in Campbelltown, a suburban hospital. J Paediatr Child Health 2015; 51:466-7. [PMID: 25828186 DOI: 10.1111/jpc.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Matthew Edwards
- Paediatrics, University of Western Sydney, Sydney, New South Wales, Australia
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Serpytis P, Petrulioniene Z, Gargalskaite U, Gedminaite A, Panaviene V. Myocardial infarction associated with Kawasaki disease in adult man: case report and review of literature. Am J Med 2015; 128:e1-3. [PMID: 25446304 DOI: 10.1016/j.amjmed.2014.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/19/2014] [Accepted: 10/20/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Pranas Serpytis
- Vilnius University, Vilnius University Hospital Santariskiu Clinics Center of Cardiology and Angiology, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - Zaneta Petrulioniene
- Vilnius University, Vilnius University Hospital Santariskiu Clinics Center of Cardiology and Angiology, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | | | | | - Violeta Panaviene
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania; Vilnius University, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
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Wei CC, Lin CL, Kao CH, Liao YH, Shen TC, Tsai JD, Chang YJ, Li TC. Increased risk of Kawasaki disease in children with common allergic diseases. Ann Epidemiol 2014; 24:340-3. [PMID: 24613197 DOI: 10.1016/j.annepidem.2014.02.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 01/29/2014] [Accepted: 02/07/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE Growing evidence reveals a link between Kawasaki disease (KD) and allergic diseases. This population-based case-control study is to investigate the onset of allergic diseases in children and the associated risks of KD. METHODS From 1996 to 2008, 2748 children with KD and 10,656 randomly selected controls were enrolled. Odds ratios of KD were calculated for the association with pre-existing allergic diseases. RESULTS The children with a single allergic disease had an increased risk of KD, with adjusted odds ratios of having KD of 1.82 for urticaria (95% confidence interval [CI], 1.54-2.14), 1.44 for allergic rhinitis (95% CI, 1.23-1.70), and 1.22 for atopic dermatitis (95% CI, 1.06-1.39). The adjusted odds ratios increased with the number of concurrent allergic diseases, from 1.61 (95% CI, 1.43-1.82) for those with only one allergic disease to 1.71 (95% CI, 1.48-1.98) for those with at least two allergic diseases. The children who made two or more medical visits for associated allergic diseases per year had an increased risk of KD. CONCLUSIONS Children with onset of allergic diseases were at increased risk for KD, and the increased risk was associated with the cumulative effect of concurrent allergic diseases and frequency of seeking medical care.
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Affiliation(s)
- Chang-Ching Wei
- Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan; Department of Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - Yen-Hsiu Liao
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Shen
- Department of Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jeng-Dau Tsai
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
| | - Tsai-Chung Li
- Department of Public Health, China Medical University, Taichung, Taiwan
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Vogel T, Kitcharoensakkul M, Fotis L, Baszis K. The heart and pediatric rheumatology. Rheum Dis Clin North Am 2013; 40:61-85. [PMID: 24268010 DOI: 10.1016/j.rdc.2013.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Recent advances in Kawasaki disease have included attempts to define genes involved in its pathogenesis. There have been recent advances in the studies of rheumatic carditis, leading to a better understanding of the mechanism of the disease. Histologic evaluation of patients with neonatal lupus erythematosus has revealed fibrosis with collagen deposition and calcification of the atrioventricular node. Therapy for cardiac involvement in systemic juvenile idiopathic arthritis should involve treatment of the underlying disease and systemic inflammatory state, and typically includes nonsteroidal antiinflammatory drugs, corticosteroids, disease-modifying drugs, and biologic therapies targeting tumor necrosis factor-alpha, interleukin-1, and interleukin-6.
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Affiliation(s)
- Tiphanie Vogel
- Division of Rheumatology, Department of Pediatrics, Washington University School of Medicine, Box 8116, One Children's Place, St Louis, MO 63110, USA; Division of Rheumatology, Department of Medicine, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
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Yim D, Curtis N, Cheung M, Burgner D. An update on Kawasaki disease II: clinical features, diagnosis, treatment and outcomes. J Paediatr Child Health 2013; 49:614-23. [PMID: 23647873 DOI: 10.1111/jpc.12221] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2012] [Indexed: 01/30/2023]
Abstract
This is the second of two updates on Kawasaki disease. The first review focused on epidemiology and aetio-pathogenesis. Here, we review the clinical features and diagnosis of Kawasaki disease, as well as recent evidence on treatment, follow-up and cardiovascular outcomes.
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Affiliation(s)
- Deane Yim
- Department of Cardiology, The University of Melbourne, Melbourne, Victoria, Australia
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Wylie KM, Weinstock GM, Storch GA. Virome genomics: a tool for defining the human virome. Curr Opin Microbiol 2013; 16:479-84. [PMID: 23706900 PMCID: PMC3755052 DOI: 10.1016/j.mib.2013.04.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/19/2013] [Accepted: 04/23/2013] [Indexed: 11/21/2022]
Abstract
High throughput, deep sequencing assays are powerful tools for gaining insights into virus-host interactions. Sequencing assays can discover novel viruses and describe the genomes of novel and known viruses. Genomic information can predict viral proteins that can be characterized, describe important genes in the host that control infections, and evaluate gene expression of viruses and hosts during infection. Sequencing can also describe variation and evolution of viruses during replication and transmission. This review recounts some of the major advances in the studies of virus-host interactions from the last two years, and discusses the uses of sequencing technologies relating to these studies.
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Affiliation(s)
- Kristine M Wylie
- The Genome Institute, Washington University School of Medicine, Campus Box 8501, 4444 Forest Park Avenue, St. Louis, MO 63108, United States.
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