Abstract
Kawasaki disease (KD) is pediatric systemic vasculitis with the classic complication of coronary artery aneurysm (CAA). It is the leading cause of acquired cardiovascular diseases in children. Some severe cases present with multi-organ involvement or neurological dysfunction. To identify the role of the glutamate receptor, ionotropic, N-methyl-d-aspartate 3A (GRIN3A) in KD, we investigated genetic variations in GRIN3A in a Taiwanese cohort of 262 KD patients (76 with and 186 without CAA complications). We used univariate and multivariate regression analyses to identify the associations between clinical characteristics and GRIN3A genetic variations in KD. According to univariate regression analysis, CAA formation in KD was significantly associated with fever duration (p < 0.0001), first Intravenous immunoglobulin (IVIG) used (days after day one of fever) (p < 0.0001), and the GRIN3A (rs7849782) genetic variant (p < 0.001). KD patients with GG+GC genotype showed a lower rate of developing CAA (GG+GC genotype: odds ratio = 0.26; 95% CI = 0.14–0.46). Significant associations were identified between KD with CAA complication and the GRIN3A (rs7849782) genetic variant by using multivariate regression analysis. Specifically, significant correlations were observed between KD with CAA complications and the presence of GG+GC genotypes for the GRIN3A rs7849782 single-nucleotide polymorphism (full model: odds ratio = 0.25; 95% CI = 0.14–0.46). Our results suggest that a polymorphism of the GRIN3A gene may play a role in KD pathogenesis.
Highlights
Kawasaki disease (KD) is acute systemic vasculitis with the classic complication of coronary artery aneurysm (CAA)
We used a mapping strategy focusing on the GRIN3A gene and identified an SNP contributing to the development of CAA formation in Taiwanese children of the
By using multivariate regression analysis, we observed a significant association between the GRIN3A gene polymorphism and the occurrence of CAA in KD patients
Summary
Kawasaki disease (KD) is acute systemic vasculitis with the classic complication of coronary artery aneurysm (CAA). It is one of the leading causes of acquired cardiovascular diseases in children [1,2,3,4,5,6]. Endothelial dysregulation leads to increased wall vulnerability accompanied by blood leaks and artery dilation [7,8]. These lesions can occur in different organs [9]. Some severe cases present with additional complications involving multiple organs or neurological dysfunction [10,11,12]
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