Asymmetric and Symmetric Dimethylarginine Are Associated with Coronary Artery Lesions in Kawasaki Disease

Abstract

To determine whether 3 biomarkers, L-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA), can predict outcomes in patients with Kawasaki disease (KD). Plasma levels of L-arginine, ADMA, and SDMA were measured in 39 patients with KD and 27 febrile control patients. Plasma L-arginine, ADMA, and SDMA levels were lower in patients with KD than in control patients before treatment with intravenous immunoglobulin (IVIG; P=.027, P<.001, and P<.001, respectively). After treatment with IVIG, L-arginine, ADMA, L-arginine/ADMA ratios, and arginine methylation ([ADMA+SDMA]/L-arginine) increased significantly (P<.001, P=.001, P=.014, and P=.001, respectively). Compared with control patients, persistent lower SDMA and higher ADMA/SDMA ratios existed in patients with KD. Furthermore, a lesser magnitude of change in terms of L-arginine and ADMA/SDMA ratios after IVIG treatment was associated with the formation of coronary dilation (P=.025, and .029, respectively). Levels of L-arginine, ADMA, and SDMA appear to be associated with KD. Lower L-arginine levels and ADMA/SDMA after treatment with IVIG was associated with coronary artery abnormalities patients with KD.