Endothelial and Platelet Function in Children With Previous Kawasaki Disease

Laurito, Marianna; Stazi, Alessandra; Delogu, Angelica Bibiana; Milo, Maria; Battipaglia, Irma; Scalone, Giancarla; Infusino, Fabio; Villano, Angelo; Russo, Giulio; Iannotta, Rossella; Saracino, Annalisa; Parrinello, Rossella; Figliozzi, Stefano; Sestito, Alfonso; Romagnoli, Costantino; Lanza, Gaetano Antonio; Crea, Filippo

doi:10.1177/0003319713502392

Cited by 24 publications

(23 citation statements)

References 37 publications

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“…The causes and clinical implications of the persistent platelet activation after the acute stage in patients with KD were probably due to the persistence of subclinical low-grade inflammation in KD (21). A recent study reported that children with a previous episode of KD showed increased platelet activation when compared with healthy participants despite no apparent vascular abnormality at follow-up (22). …”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Platelet-derived Microparticle as Biomarker of Antiplatelet Therapy in Kawasaki Disease

et al. 2017

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Little is known about platelet dynamics and the effect of antiplatelet therapy in Kawasaki disease (KD). This study sought to define platelet activation dynamics in KD patients by assaying platelet-derived microparticles (PDMPs). We measured plasma PDMPs levels in 46 patients with KD using an enzyme-linked immunosorbent assay (ELISA). Blood samples were collected before, at 2–5 days, and 9–15 days after intravenous immunoglobulin (IVIG) infusion, 2 months and 4–5 months after the onset of KD. We measured PDMP levels in 23 febrile and 10 afebrile control patients. In the acute phase of KD patients, PDMP levels increased significantly after IVIG treatment (12.04 ± 5.58 nmol before IVIG infusion vs. 19.81 ± 13.21 nmol at 2–5 days after IVIG infusion, P = 0.006). PDMP levels were negatively correlated with age and positively correlated with procalcitonin levels in the acute phase of KD. No significant difference was found in PDMP levels between KD patients with and without coronary artery lesion (CAL). Elevated PDMP levels after IVIG therapy significantly decreased below the pre-IVIG level in subacute phase (19.81 ± 13.21 nmol at 2–5 days after IVIG infusion vs. 8.33 ± 2.02 nmol at 9–15 days after IVIG infusion, P < 0.001), and PDMP levels stayed below the pre-IVIG level in the convalescent phase, during which antiplatelet therapy was given. However, PDMP levels rebounded after discontinuing aspirin in 17 patients. In conclusion, enhanced platelet activation was noted before treatment of KD and peaked immediately after IVIG treatment. Recurrent rising of PDMP levels was observed after discontinuing aspirin, although there were no significant differences between the PDMP levels at 2 months after the onset of KD and those at 4–5 months after the onset of the disease.

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Section: Discussionmentioning

confidence: 99%

The Usefulness of Platelet-derived Microparticle as Biomarker of Antiplatelet Therapy in Kawasaki Disease

et al. 2017

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“…On the other hand, a recent Dutch study noted a small increase in cIMT in participants with a history of KD regardless of the presence of aneurysms in the subacute phase . Only two studies focus exclusively on KD patients without coronary artery changes or with transient coronary artery dilatations and both have small sample sizes; neither detected any differences in cIMT compared to controls . Overall, irrespective of ethnicity, studies performed on average less than 10 years since acute KD are more likely to detect increased cIMT compared to controls, although data are inconsistent .…”

Section: Resultsmentioning

confidence: 92%

“…Three studies show no changes in FMD; 2 studies have less than 15 KD patients each . McCrindle et al found no difference in FMD in predominantly European patients with persistent coronary aneurysms despite metabolic and lipid abnormalities .…”

Section: Resultsmentioning

confidence: 99%

Kawasaki disease and cardiovascular risk: a comprehensive review of subclinical vascular changes in the longer term

et al. 2016

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“…Two patients also received IV in iximab infusion (5 mg/kg)-one child with giant coronary artery aneurysm and the other with severe systemic disease and transient CAA. Antiplatelet dose of aspirin was continued for 3 months in one child as he persisted in having elevated platelet counts (640x10 9 No signi cant differences in MPA% were noted between patients with and without CAAs […”

Section: Resultsmentioning

confidence: 99%

“…Occurrence of coronary thrombosis and premature arteriosclerosis in KD suggests that excess activation of platelets and coronary vasculitis may play an important role in progression of vascular damage in KD. Though platelet activation has been studied in KD, there is paucity of literature on ow cytometry-based assessment of leukocyte-platelet aggregates in KD and there are no data from developing countries (7)(8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Monocyte Platelet Aggregates in Children with Kawasaki Disease- a Preliminary Study from a Tertiary Care Centre in North-West India

Vignesh

Rawat

Shandilya

et al. 2020

Preprint

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Background: Platelet activation is an integral part of pathogenesis of Kawasaki disease (KD). However, there is paucity of literature on flow-cytometry based assessment of platelet activation in KD. We aimed to analyse monocyte-platelet aggregates (MPAs), one of the sensitive markers for platelet activation, by flow cytometry in children with KD.Findings: In this single-centre prospective study, we have enrolled 14 children with KD and results were compared with age-matched febrile (n=15) and healthy (n=13) controls. After gating monocytes in side-scatter plot, MPAs were identified based on CD14 and CD41 expression. Two (2) ml of blood samples for children with KD were collected at 3 phases of illness- acute stage before start of intravenous immunoglobulin or aspirin, 24 hours after completion of IVIg infusion, and 3 months after acute episode of KD. Children with KD had a significantly higher MPA% values [Median (IQR)- 41.3% (26.6, 52.7)] when compared with febrile [Median (IQR)- 5.98% (2.98-9.72)] and normal [Median (IQR)- 4.48% (2.57-5.59)] controls, p<0.01. On follow-up, the MPA% showed a gradual decline in children with KD, but even at 3 months, the value [Median (IQR)- 7.55% (4.15-14.6)] was higher compared to healthy controls [Median (IQR)- 4.48% (2.57-5.59)].Conclusions: Our results suggest that MPA% was significantly elevated in acute stages in children with KD and activated platelets may continue to persist even after systemic inflammation has subsided. Future studies are warranted whether objective evidence of platelet activation may guide the use of immunomodulatory and anti-platelet therapy in KD.

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Endothelial and Platelet Function in Children With Previous Kawasaki Disease

Cited by 24 publications

References 37 publications

The Usefulness of Platelet-derived Microparticle as Biomarker of Antiplatelet Therapy in Kawasaki Disease

The Usefulness of Platelet-derived Microparticle as Biomarker of Antiplatelet Therapy in Kawasaki Disease

Kawasaki disease and cardiovascular risk: a comprehensive review of subclinical vascular changes in the longer term

Monocyte Platelet Aggregates in Children with Kawasaki Disease- a Preliminary Study from a Tertiary Care Centre in North-West India

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