Acute phase of Kawasaki disease: a review of national guideline recommendations

Scherler, Laura; Haas, Nikolaus A.; Tengler, Anja; Pattathu, Joseph; Mandilaras, Guido; Jakob, André

doi:10.1007/s00431-022-04458-z

Cited by 20 publications

(19 citation statements)

References 37 publications

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“…e duration of treatment is 6-8 weeks in KD patients without CAA. However, in patients with CAA, antiplatelet therapy is continued until resolution of the lesions or indefinitely in case of persistence [12][13][14]. Nakada's retrospective analysis showed that children receiving IVIG and aspirin at the same time can reduce the incidence of coronary artery disease [15].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Mechanism of Aspirin in the Treatment of Kawasaki Disease Based on Molecular Docking and Molecular Dynamics

Xiong

Cao

Qiu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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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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Section: Introductionmentioning

confidence: 99%

Exploring the Mechanism of Aspirin in the Treatment of Kawasaki Disease Based on Molecular Docking and Molecular Dynamics

Xiong

Cao

Qiu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…However, these clinical presentations are not often present at the same time or in the typical order of appearance [ 57 ]. Furthermore, only 70% to 80% of patients completely fulfill the KD criteria, and this percentage decreases in younger children [ 58 ]. Therefore, doctors who only suspect KD must perform repeat histories and careful examinations to timeously diagnose KD in FC.…”

Section: Discussionmentioning

confidence: 99%

Combination of Hemoglobin-for-Age Z-Score and Plasma Hepcidin Identified as a Novel Predictor for Kawasaki Disease

et al. 2022

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Kawasaki disease (KD) is a febrile coronary vasculitis that affects younger children and includes complications such as coronary artery aneurysm. KD diagnoses are diagnosed based on clinical presentations, a process that still poses a challenge for front-line physicians. In the current study, we developed a novel predictor using the hemoglobin-for-age z-score (HbZ) and plasma hepcidin to differentiate Kawasaki disease (KD) from febrile children (FC). There were 104 FC and 115 KD subjects (89 typical KD; 26 incomplete KD) for this study, and data were collected on the biological parameters of hemoglobin and plasma hepcidin levels. A receiver operating characteristic curve (auROC), multiple logistics regression, and support vector machine analysis were all adopted to develop our prediction condition. We obtained both predictors, HbZ and plasma hepcidin, for distinguishing KD and FC. The auROC of the multivariate logistic regression of both parameters for FC and KD was 0.959 (95% confidence interval = 0.937–0.981), and the sensitivity and specificity were 85.2% and 95.9%, respectively. Furthermore, the auROC for FC and incomplete KD was 0.981, and the sensitivity and specificity were 92.3% and 95.2%, respectively. We further developed a model of support vector machine (SVM) classification with 83.3% sensitivity and 88.0% specificity in the training set, and the blind cohort performed well (78.4% sensitivity and 100% specificity). All data showed that sensitivity and specificity were 81.7% and 91.3%, respectively, by SVM. Overall, our findings demonstrate a novel predictor using a combination of HbZ and plasma hepcidin with a better discriminatory ability for differentiating from WBC and CRP between children with KD and other FC. Using this predictor can assist front-line physicians to recognize and then provide early treatment for KD.

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“…A high dose of intravenous immunoglobulin (IVIG, 2mg/kg) and aspirin are the standard treatment for KD and was shown to be effective in decreasing aneurysm formation from 20–25% to 3–5% [ 1 , 2 ].The definition of incomplete KD and IVIG-resistance treatment vary to some extent between the country-specific national guidelines. Only IVIG for initial treatment of KD is consistently proposed throughout all guidelines, further therapeutic recommendations vary between the several national recommendations [ 3 ].…”

Section: Discussionmentioning

confidence: 99%