Elevated Plasma Apurinic/Apyrimidinic Endonuclease 1/Redox Effector Factor-1 Levels in Refractory Kawasaki Disease.

Yu-Ran Lee,Hong Ryang Kil,Eun Young Bae,Byeong-Hwa Jeon,Geena Kim

doi:10.3390/biomedicines10010190

Yu-Ran Lee, Hong Ryang Kil + Show 3 more

Open Access

https://doi.org/10.3390/biomedicines10010190

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Abstract

Kawasaki disease (KD) refers to systemic vasculitis of medium-sized vessels accompanied by fever. The multifunctional protein apurinic/apyrimidinic endonuclease-1/redox factor-1 (APE1/Ref-1) is a new biomarker for vascular inflammation. Here, we investigated the association between APE1/Ref-1 and KD. Three groups, including 32 patients with KD (KD group), 33 patients with fever (Fever group), and 19 healthy individuals (Healthy group), were prospectively analyzed. APE1/Ref-1 levels were measured, and the clinical characteristics of KD were evaluated. The mean age of all patients was 2.7 ± 1.8 years, but the Healthy group participants were older than the other participants. Fever duration was longer in the KD group than in the fever group. APE1/Ref-1 levels were significantly higher in the KD group (p = 0.004) than in the other two groups, but there was no difference between the healthy and fever groups. APE1/Ref-1 levels did not differ according to fever duration or coronary arterial lesion but were higher in refractory KD cases than in non-refractory cases. APE1/Ref-1 levels were significantly higher during the acute phase of KD. We propose that APE1/Ref-1 could be a beneficial biological marker for the diagnosis and prognosis of KD, especially in refractory KD.

Highlights

Kawasaki disease (KD) is an acute febrile disease diagnosed in young children or infants aged less than 6 years [1]
This disease may be accompanied by diverse cardiovascular complications such as coronary aneurysms, heart failure in the acute complication stage, and myocardial infarction in patients with large coronary aneurysms, and these complications are more likely associated with refractory KD
The KD group was evaluated for N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels

Summary

Introduction

Kawasaki disease (KD) is an acute febrile disease diagnosed in young children or infants aged less than 6 years [1]. Kawasaki and Naoe reported KD in 1967 [2] It is characterized by a persistent fever above 38 °C over 5 days, and its clinical symptoms include nonsuppurative bilateral conjunctival injection, red lips, strawberry tongue, atypical exanthema, cervical lymph node enlargement, swelling and erythema of hands and feet, and membranous desquamation [3]. Intravenous immune globulin is the standard treatment for the acute stage of KD [3]. This disease may be accompanied by diverse cardiovascular complications such as coronary aneurysms, heart failure in the acute complication stage, and myocardial infarction in patients with large coronary aneurysms, and these complications are more likely associated with refractory KD.

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