Breastfeeding and Risk of Kawasaki Disease: A Nationwide Longitudinal Survey in Japan

Yorifuji, Takashi; Tsukahara, Hirokazu; Doi, Hiroyuki

doi:10.1542/peds.2015-3919

Cited by 42 publications

(33 citation statements)

References 21 publications

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“…Our study provide further evidence for the promotion of breast-feeding. A large study from Japan has indicated that breastfeeding may be protective for KD [16], our data reinforce the findings.…”

Section: Discussionsupporting

confidence: 90%

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Breastfeeding Reduce the Risk of Kawasaki Disease in a Chinese Population Based Case-Control Study

Yang

2020

Preprint

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Backgroud: Kawasaki disease (KD) is the leading cause of acquired heart disease in the pediatric age group in developed countries. But its etiology is unknown. We assessed whether brestfeeding time can influence risk of KD. Methods: We collected feeding, clinical and laboratory details from 200 KD patients and 100 controls. Then we use SPSS to assess the comparison of the general characteristics of KD patients and control patients, and the Correlation of BF time with clinical and laboratory of KD patients. Results: The haemoglobin level was significantly lower in Kawasaki disease patients compared with controls (p<0.05). There were no significant differences between group of KD with coronary artery lesions (CALs) and group of KD without CALs in age, sex, WBC, platelet, HB, CRP . However, there were significantly decreased frequencies for the longer beestfeeding time in KD patients without CALs when compared with KD patients with CALs (OR=668, 95%CI=0.454-0.984，p=0.041). Moreover, HB level were positively correlated with brestfeeding time in patients with KD (r=0.163, p=0.028) Conclusion: We have shown that breast-feeding is associated with KD and the CALs. Brestfeeding may reduce the risk or KD with CALs. Brestfeeding may reduce the risk of KD with CALs.

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Section: Discussionsupporting

confidence: 90%

“…A Japanese study and a German study already have indicated a potential protective effect of brestfeeding in KD [6,7]. This suggested that brestfeeding potentially play a role in the pathogenesis of KD.…”

Section: Introductionmentioning

confidence: 92%

Breastfeeding Reduce the Risk of Kawasaki Disease in a Chinese Population Based Case-Control Study

Yang

2020

Preprint

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“…Late or post term birth [ 27 ] and not being breastfed as an infant [ 28 ] are known to be associated with multiple immunological diseases, including allergies, which are themselves associated with an increased risk of KD [ 29 – 31 ]. The association between late or post term birth and increased risk of KD was also observed in the present study.…”

Section: Discussionmentioning

confidence: 99%

Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distribution

et al. 2018

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BackgroundThe pathogenesis of Kawasaki disease (KD) is commonly ascribed to an exaggerated immunologic response to an unidentified environmental or infectious trigger in susceptible children. A comprehensive framework linking epidemiological data and global distribution of KD has not yet been proposed.Methods and findingsPatients with KD (n = 81) were enrolled within 6 weeks of diagnosis along with control subjects (n = 87). All completed an extensive epidemiological questionnaire. Geographic localization software characterized the subjects’ neighborhood. KD incidence was compared to atmospheric biological particles counts and winds patterns. These data were used to create a comprehensive risk framework for KD, which we tested against published data on the global distribution. Compared to controls, patients with KD were more likely to be of Asian ancestry and were more likely to live in an environment with low exposure to environmental allergens. Higher atmospheric counts of biological particles other than fungus/spores were associated with a temporal reduction in incidence of KD. Finally, westerly winds were associated with increased fungal particles in the atmosphere and increased incidence of KD over the Greater Toronto Area. Our proposed framework was able to explain approximately 80% of the variation in the global distribution of KD. The main limitations of the study are that the majority of data used in this study are limited to the Canadian context and our proposed disease framework is theoretical and circumstantial rather than the result of a single simulation.ConclusionsOur proposed etiologic framework incorporates the 1) proportion of population that are genetically susceptible; 2) modulation of risk, determined by habitual exposure to environmental allergens, seasonal variations of atmospheric biological particles and contact with infectious diseases; and 3) exposure to the putative trigger. Future modelling of individual risk and global distribution will be strengthened by taking into consideration all of these non-traditional elements.

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“…Diagnosis of KD prior to six months of age is rare and the normal peak in toddlers generally suggests a protective role of maternal antibodies during early development [ 17 ]. Recent studies show a lower incidence in breastfed infants further supporting protection by antibodies [ 18 ]. Other data support a role of B cell responses in the pathogenesis of KD.…”

Section: Introductionmentioning

confidence: 99%

Suppressed plasmablast responses in febrile infants, including children with Kawasaki disease

2018

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BackgroundKawasaki disease (KD), the leading cause of acquired heart disease in children, primarily affects infants and toddlers. Investigations on immune responses during KD are hampered by a limited understanding of normal immune responses in these ages. It’s well known that Infants have poorer vaccine responses and difficulty with maintaining prolonged serum immunity, but there are few studies on human infants detailing immune deficiencies. Limited studies propose an inability to maintain life-long bone marrow plasma cells. Plasmablasts are a transitional cell form of B cells that lead to long-term Plasma cells. Plasmablasts levels rise in the peripheral blood after exposure to a foreign antigen. In adult studies, these responses are both temporally and functionally well characterized. To date, there have been few studies on plasmablasts in the predominant age range of KD.MethodsChildren presenting to an urban pediatric emergency room undergoing laboratory evaluation, who had concern of KD or had fever and symptoms overlapping those of KD, were recruited. Peripheral blood mononuclear cells were isolated and evaluated utilizing flow cytometry with specific B cell markers from 18 KD subjects and 69 febrile controls.ResultsPlasmablast numbers and temporal formation are similar between infectious disease controls and KD subjects. In both groups, infants have diminished plasmablast responses compared to older children.ConclusionIn this single-time point survey, infants have a blunted peripheral plasmablast response. Overall, similar plasmablast responses in KD and controls support an infectious disease relationship to KD. Future time-course studies of plasmablasts in infants are warranted as this phenomenon may contribute to observed immune responses in this age group.

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Breastfeeding and Risk of Kawasaki Disease: A Nationwide Longitudinal Survey in Japan

Cited by 42 publications

References 21 publications

Breastfeeding Reduce the Risk of Kawasaki Disease in a Chinese Population Based Case-Control Study

Breastfeeding Reduce the Risk of Kawasaki Disease in a Chinese Population Based Case-Control Study

Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distribution

Suppressed plasmablast responses in febrile infants, including children with Kawasaki disease

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Breastfeeding and Risk of Kawasaki Disease: A Nationwide Longitudinal Survey in Japan

Cited by 42 publications

References 21 publications

Breastfeeding&nbsp;Reduce the Risk of&nbsp;Kawasaki Disease&nbsp;in a Chinese Population&nbsp;Based&nbsp;Case-Control Study

Breastfeeding&nbsp;Reduce the Risk of&nbsp;Kawasaki Disease&nbsp;in a Chinese Population&nbsp;Based&nbsp;Case-Control Study

Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distribution

Suppressed plasmablast responses in febrile infants, including children with Kawasaki disease

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Breastfeeding Reduce the Risk of Kawasaki Disease in a Chinese Population Based Case-Control Study

Breastfeeding Reduce the Risk of Kawasaki Disease in a Chinese Population Based Case-Control Study