The Relationship between Retinol-Binding Protein 4 and Markers of Inflammation and Thrombogenesis in Children with Kawasaki Disease

Abstract

Background. Kawasaki disease (KD) is a self-limited vasculitis with unknown etiologies, and coronary artery lesions (CALs) are the most common and serious complications. Retinol-binding protein 4 (RBP4) has been confirmed effects on vasodilation, platelet activation inhibition, and cardiovascular diseases by researches. Therefore, this study was aimed at investigating the relationship between RBP4 and inflammation as well as thrombogenesis in children with KD. Methods. 79 subjects were from 62 children with KD and 17 healthy controls (HCs). The KD group was divided into KD with CALs (KD-CALs) and KD without CALs (KD-NCALs), and the serum RBP4 levels were measured by enzyme-linked immunosorbent assay (ELISA). Results. Compared with the HC group, serum RBP4 levels in the KD group were significantly decreased ( p < 0.05 ). RBP4, hemoglobin (Hb), and mean platelet volume (MPV) levels were higher, while platelet counts (Plt) and thrombin time (TT) levels were lower in the KD-NCALs group than in the KD-CALs group ( p < 0.05 ). RBP4 had positive correlation with time point of intravenous immunoglobulin (IVIG), Hb, and percentage of leukomonocytes (L%) and negative correlation with the percentage of neutrophils (N%), MPV, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), prothrombin time (PT), fibrinogen (Fbg), and D-dimer (DD) in the KD group; RBP4 had positive correlation with the time point of IVIG and L% and negative correlation with N%, MPV, and NLR in the KD-NCALs group; and RBP4 had positive correlation with Hb and L% and negative correlation with N%, CRP, NLR, and PT in the KD-CALs group ( p < 0.05 ). Multiple linear regression analysis confirmed that Hb and CRP in the KD group, MPV and N% in the KD-NCALs group, and PT and CRP in the KD-CALs group were independent predictors of RBP4 ( p < 0.05 ). Conclusion. Lower RBP4 was observed in the KD group than in the HC group, and RBP4 had associations with markers of inflammation and thrombogenesis in children with KD.

Neutrophil to Lymphocyte Ratio as a Biomarker for Predicting the Coronary Artery Abnormality in Kawasaki Disease: A Meta-Analysis

“…There is growing evidence that both innate and adaptive immune cells mediate the systemic and tissue-specific effects of KD-like CA aneurysms [9]. In light of this, several studies have suggested that NLR calculation may aid in the clinical assessment of the inflammatory aspect of KD, serving as a metric for risk stratification and prediction for adverse cardiac events in adulthood [13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

“…Finally, 17 articles with 6334 KD patients, of whom 1328 developed CAA, were enrolled in this meta-analysis [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. The list of included studies is shown in supplementary file B.…”

All-trans-Retinoic Acid Alleviates Coronary Stenosis by Regulating the Migration of Smooth Muscle Cells in a Mouse Model of Kawasaki Disease

“…Kimura et al showed that RBP4, which is a candidate diagnostic marker, was decreased in patients with acute KD 24 . Recently, Yang et al reported that KD patients had signi cantly lower RBP4 levels than healthy controls, suggesting that RBP4, which is a main retinol transport protein, is closely associated with markers of in ammation and thrombogenesis in children with KD 25,26 .…”

Thromboinflammatory Processes at the Nexus of Metabolic Dysfunction and Prostate Cancer: The Emerging Role of Periprostatic Adipose Tissue

“…Although the precise mechanisms are poorly understood, RBP4 was suggested to modulate the crosstalk between AT dysfunction and the development of cancer [ 308 ]. Indeed, RBP4 is associated with the enhanced thrombogenicity of procoagulant states and knocking down RBP4 inhibits the growth of PC-3 cells in vitro [ 309 , 310 , 311 ]. Therefore, the possible roles of RBP4 at the intersection of these pathologies warrants further investigation.…”