A meta-analysis of the biomarkers associated with coronary artery lesions secondary to Kawasaki disease in Chinese children

Chen, Jingjing; Liu, Yali; Liu, Wenhua; Wu, Zhengzheng

doi:10.1007/s11596-011-0587-9

Cited by 33 publications

(27 citation statements)

References 24 publications

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“…Serum CRP level is increased in patients with myocardial ischemia and sudden death due to coronary artery disease (28). Previous studies have shown that elevated ESR in KD patients is disadvantageous to the prognosis of CAL (29). In our study, CRP was significantly higher in patients with CAL, and it was also revealed that PLT was significantly higher in KD patients with CAL, possibly related to vascular inflammation and activation of the coagulation system.…”

Section: Discussionsupporting

confidence: 63%

Plasma MASP-1 concentration and its relationship to recovery from coronary artery lesion in children with Kawasaki disease

Song

Zou

et al. 2015

Pediatr Res

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Background: This study investigated prognostic factors for early recovery of coronary artery lesion (CAL) in children with Kawasaki disease (KD). Methods: Patients hospitalized for KD were enrolled less than 2 wk from the onset of illness and divided into two groups: KD with CAL and KD without CAL. The CAL group was further divided into two subgroups according to the degree of CAL: mild (n = 31) and moderate/severe (n = 6) and further divided into two subgroups according to the age: younger than 1 y (n = 9) and older than 1 y (n = 28). Lectin pathway-related factors MASP-1, CD59, and C5b-9 were measured, along with C-reactive protein, white blood cell counts, erythrocyte sedimentation rate, and platelet count. Patients were followed up for 3 mo. Correlation between the measured factors and the length of time of recovery from CAL was analyzed. results: Plasma concentrations of MASP-1 in the CAL group were significantly lower than those without CAL. MASP-1 and gender positively correlated with the recovery time of CAL. There was no difference in MASP-1 between mild and moderate/severe CAL. At 3-mo follow-up, there was a positive correlation between plasma MASP-1 concentration and recovery time of the patients with CAL older than 1 y. conclusion: Plasma MASP-1 concentration at the early stage of KD is predictive of length of time of recovery from CAL. k awasaki disease (KD), also known as mucocutaneous lymph node syndrome, is an acute nonspecific systemic vascular inflammatory syndrome occurring mainly in children under 5 y of age. A considerable volume of research has shown that the pathological process of KD is characterized by immune activation and immune vasculitis of the vascular endothelial cells (1). KD mostly affects the small and mediumsized arteries, especially the coronary artery (2), resulting in coronary artery lesion (CAL), such as dilation, aneurysm formation, or advanced stenosis, and it is the leading cause of death in children with KD (3). It has been reported that 15-25% of untreated KD patients may develop CAL (4). Although treatment with intravenous immunoglobulin within 10 d of onset of fever reduces the incidence of CAL, 5-8% of patients still develop it. The degree of CAL varies considerably between individuals, ranging from mild to moderate ectasia of the coronary artery to giant aneurysm formation. The recovery time of CAL also differs between patients. There is a very little information about the length of time for which different degrees of CAL persists. Little is known on the relationship between the complement system and the recovery time of CAL resulting from KD. Our previous study indicated that the lectin pathway of the complement system is activated in KD. CAL is associated with endothelial cell dysfunction induced by T-cell activation (5). Endothelial cells are a source of complement-related factors and complement regulatory factors (6), and MASP-1 activates endothelial cells directly, which then activates the complement lectin pathway (7). Endothelial cell dysfunction (8) and com...

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Section: Discussionsupporting

confidence: 63%

Plasma MASP-1 concentration and its relationship to recovery from coronary artery lesion in children with Kawasaki disease

Song

Zou

et al. 2015

Pediatr Res

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“…A host of traditional markers of inflammation and myocardial injury are higher in KD with than without coronary artery involvement, but not enough to guide decision making [54]. Baseline NT-proBNP also might help distinguish patients who develop coronary artery lesions (despite IVIG) from those who do not, but imperfectly [55].…”

Section: Kawasaki Diseasementioning

confidence: 99%

Biomarkers in vasculitis

Monach

2014

Current Opinion in Rheumatology

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Purpose of review Better biomarkers are needed for guiding management of patients with vasculitis. Large cohorts and technological advances had led to an increase in pre-clinical studies of potential biomarkers. Recent findings The most interesting markers described recently include a gene expression signature in CD8+ T cells that predicts tendency to relapse or remain relapse-free in ANCA-associated vasculitis, and a pair of urinary proteins that are elevated in Kawasaki disease but not other febrile illnesses. Both of these studies used “omics” technologies to generate and then test hypotheses. More conventional hypothesis-based studies have indicated that the following circulating proteins have potential to improve upon clinically available tests: pentraxin-3 in giant cell arteritis and Takayasu’s arteritis; von Willebrand factor antigen in childhood central nervous system vasculitis; eotaxin-3 and other markers related to eosinophils or Th2 immune responses in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome); and MMP-3, TIMP-1, and CXCL13 in ANCA-associated vasculitis. Summary New markers testable in blood and urine have the potential to assist with diagnosis, staging, assessment of current disease activity, and prognosis. However, the standards for clinical usefulness, in particular the demonstration of either very high sensitivity or very high specificity, have yet to be met for clinically relevant outcomes.

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“…In patients with incomplete KD, the acute and sub-acute age-corrected hemoglobin levels were reduced; however, the sub-acute platelet counts increased in patients with complete KD. Furthermore, it is known that the platelet counts in KD patients are positively correlated with fever duration, and a longer inflammation period may be reflected in the increase in platelet counts (27). Jeon et al (28) observed that coronary artery aneurysms developed in 30 of 392 patients with KD within a month of diagnosis while in 20% they persisted even after 1 year of follow-up.…”

Section: Assignment -------------------------------------------------mentioning

confidence: 99%

Utility of color Doppler echocardiography combined with clinical markers in diagnosis and prediction of prognosis of coronary artery lesions in Kawasaki disease

Xue

Wang

2020

Exp Ther Med

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The utility of color Doppler echocardiography in the diagnosis and follow-up of Kawasaki disease (KD) with coronary artery lesions (CAL) was analyzed, and the clinical parameters associated with the disease were examined. The general data, the color Doppler echocardiography data and the biochemical indexes from 102 children with KD were analyzed. The patients were divided into a CAL group and a non-coronary artery lesion (NCAL) group based on the presence or absence of CAL. The risk factors for CAL in KD were screened by univariate and multivariate analyses. Among the 102 cases, CAL complications were identified in 47 cases (46.08%). Compared with the NCAL group, the CAL group showed significantly higher incidences of fever duration, increased levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), C-reactive protein (CRP), intravenous immunoglobulin resistance, erythrocyte sedimentation rate (ESR), platelets, alanine aminotransferase and aspartate aminotransferase, and significantly lower serum albumin levels (P<0.05). According to the multivariate analysis, fever duration [odds ratio (OR)=2.014], NT-proBNP (OR=3.004), cTnI level (OR=2.638), ESR (OR=1.461) and CRP elevation (OR=1.094) were predictors of CAL in KD. During convalescence, the left and right coronary artery diameters in the CAL group significantly decreased (P<0.05). Color Doppler echocardiography can observe the condition of coronary artery disease in patients with KD in real time and predicts its outcomes, which may be helpful for early diagnosis and long-term follow-up. Fever duration, cTnI, NT-proBNP and ESR levels were correlated with coronary artery diameter, of which the comprehensive use may be more accurate in determining the occurrence of CAL in KD.

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A meta-analysis of the biomarkers associated with coronary artery lesions secondary to Kawasaki disease in Chinese children

Cited by 33 publications

References 24 publications

Plasma MASP-1 concentration and its relationship to recovery from coronary artery lesion in children with Kawasaki disease

Plasma MASP-1 concentration and its relationship to recovery from coronary artery lesion in children with Kawasaki disease

Biomarkers in vasculitis

Utility of color Doppler echocardiography combined with clinical markers in diagnosis and prediction of prognosis of coronary artery lesions in Kawasaki disease

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