Aetiological Significance of Infectious Stimuli in Kawasaki Disease

Abstract

Kawasaki disease (KD) is a pediatric vasculitis syndrome that is often involves coronary artery lesions (e. g., coronary artery aneurysms). Although its causal factors and entire pathogenesis remain elusive, the available evidence indicates that the pathogenesis of KD is closely associated with dysregulation of immune responses to various viruses or microbes. In this short review, we address several essential aspects of the etiology of KD with respect to the immune response to infectious stimuli: 1) the role of viral infections, 2) the role of bacterial infections and the superantigen hypothesis, 3) involvement of innate immune response including pathogens/microbe-associated molecular patterns and complement pathways, and 4) the influence of genetic background on the response to infectious stimuli. Based on the clinical and experimental evidence, we discuss the possibility that a wide range of microbes and viruses could cause KD through common and distinct immune processes.

Kawasaki Disease Following Severe Sunburn Injury

“…Kawasaki disease (KD) is an acute, febrile and systemic vasculitis that primarily occurs in infants and young children (1). Although its etiology is unknown, an aberrant innate immune system in predisposed individuals has been proposed to play a key role in the development of KD vasculitis (2,3). Several studies suggest a possibility that KD-specific innate immune pathogen-associated molecular patterns (PAMPs)/microbe-associated molecular patterns (MAMPs) induce vascular inflammation, leading to the development of KD (2,3).…”

“…Although its etiology is unknown, an aberrant innate immune system in predisposed individuals has been proposed to play a key role in the development of KD vasculitis (2,3). Several studies suggest a possibility that KD-specific innate immune pathogen-associated molecular patterns (PAMPs)/microbe-associated molecular patterns (MAMPs) induce vascular inflammation, leading to the development of KD (2,3). PAMPs/MAMPs also induce damageassociated molecular patterns (DAMPs) production, such as S100 proteins and high mobility group box 1 (HMGB1), by host cells (3).…”

SARS-CoV-2 Inflammatory Syndrome. Clinical Features and Rationale for Immunological Treatment

“…Thus, it resembles the inflammatory syndromes that may complicate anti-phospholipid antibody syndrome (APS), namely the catastrophic anti-phospholipid syndrome (CAPs), characterized by disseminated intravascular microthrombosis [29]; or, the systemic CLLS characterized by altered capillary wall permeability [30]. Besides CAPs and CLLS, the SARS-CoV-2 inflammation, leading to ARDS, shares pathogenic mechanisms and clinical-radiological aspects with other auto-immune/-inflammatory diseases, such as juvenile idiopathic arthritis and its adult form [31][32][33] and Kawasaki disease [34]. Systemic CLLS has also been observed in Kawasaki disease [35].…”

What's the relation between paranasal sinusitis (based on PNS-CT scan) and Kawasaki disease: A comparative study in children in Tehran, Iran

“…According to the American Heart Association (AHA) criteria fever lasting more than 5 days is essential for KD diagnosis with two or three principal clinical features of KD) without a known infection source. (6) The super antigen hypothesis; immune response, and genetic background on the response to infectious stimuli discussed by some authors (7)(8)(9). Nagata reported causes of KD in pediatrics (7) Nakamura et al studied etiological signi cance of infectious stimuli in KD (8).…”

“…(6) The super antigen hypothesis; immune response, and genetic background on the response to infectious stimuli discussed by some authors (7)(8)(9). Nagata reported causes of KD in pediatrics (7) Nakamura et al studied etiological signi cance of infectious stimuli in KD (8). According to Menikou et al study, immune complexes has signi cant role in pediatric KD (9).Lloyd et al discussed infectious agent as etiologic factor in KD (10).…”