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Kawasaki disease is an acute, systemic vasculitis that easily injures coronary arteries and is the leading cause of acquired heart disease in children.Although the cause of Kawasaki disease remains unknown, it is widely believed that the pathogenesis of Kawasaki disease is an inflammatory cascade caused by a combination of infection and genetic predisposition.Regulatory T cells, which express Foxp3 + , CD4 + and CD25 + , are a T-cell subpopulation specialized in immune suppression.There are some correlations between regulatory T cells and Kawasaki disease in pathophysiology, treatment and prognosis.The dysfunction of regulatory T cells may be involved with the pathogenesis of Kawasaki disease, but there are few researches on it.This article reviews the progress of regulatory T cells in Kawasaki disease in recent years and summarizes the mechanism of regulatory T cells in the occurrence and repair of Kawasaki disease, prospecting the research future of targeted regulatory T cells therapy in the prevention of coronary artery lesions in Kawasaki disease.
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Laboratory testing plays an important role in the diagnosis and treatment of patients with novel coronavirus pneumonia. However, the lack of understanding of the virus in the early stage led to great difficulties in biosafety protection for clinical laboratories. Based on the latest researches and findings about the virus, this paper provides some personal opinions on the biosafety prevention in clinical laboratorians under epidemic condition for the reference of laboratory workers.
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Laboratory testing plays an important role in the diagnosis and treatment of patients with Novel Coronavirus pneumonia. However, the lack of understanding of the virus in the early stage led to great difficulties in biosafety protection for clinical laboratories. Based on the latest researches and findings about the virus, this paper provides some personal opinions on the biosafety prevention in clinical laboratorians under epidemic condition for the reference of laboratory workers.
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Kawasaki disease(KD) is an acute febrile vasculitis and approximate 10% to 20% children with KD are resistant to initial intravenous immunoglobulin(IVIG) treatment at a dose of 2 g/kg, who are named IVIGRKD.Treatments for IVIGRKD include second dose IVIG, second dose IVIG plus glucocorticoid, single intravenous injection of infliximab, intravenous or oral cyclosporine, subcutaneous injection of Anakinra, intravenous cyclophosphamide, and plasma exchange, etc.No evidence suggests which treatment method is better than the others.Therefore, early prediction and timely identification of IVIGRKD are extremely important.Unfortunately, most of current prediction models are based on the statistical analysis of retrospective data, and due to the discrepancy of region and race, their further application are limited.
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Kawasaki disease has replaced rheumatic fever as the most common acquired heart disease in childhood,but its etiology remains unknown. The development and analyses of animal models will help us under-stand KD and find new and effective therapeutic strategies for it. Among these existing animal models, mouse modelof coronary artery inflammation induced by a single intraperitoneal injection of lactobacillus casei cell wall extract is a relatively mature model. In this review,we present an overview of how this model established and some progress in research of the mouse model.
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<p><b>OBJECTIVE</b>To investigate the course of coronary artery lesions caused by Kawasaki disease, and the value of coronary angiography (CAG) and two-dimensional echocardiography (2-D Echo) in the evaluation and follow-up of coronary artery lesions.</p><p><b>METHODS</b>Eighty seven patients with coronary artery lesions caused by Kawasaki disease from 1979 to 1997 were retrospectively analyzed. One hundred and sixty-seven CAGs were performed in 87 patients during follow-up. CAG was repeated every 1-3 years in each patient until complete regression was confirmed. 2-D Echo was performed before CAG each time. The longest period of follow-up was 16 years and 6 months. Patients were treated with aspirin or aspirin and warfarin.</p><p><b>RESULTS</b>During follow-up, the coronary artery lesions regressed in 48/87 (55%) patients, however, they developed into severe coronary artery lesions in 6/87 (7%) patients in whom coronary artery bypass surgery was performed. The coronary artery aneurysm regressed in some patients, while stenotic lesions remained or developed. The ratio of coronary artery stenotic lesions to aneurysms increased progressively. This study showed that Echo diagnosis of coronary artery lesions has "false positives" and "false negatives". Only 76% of coronary aneurysms and 18% of stenotic lesions could be found by 2-D Echo. No stenotic lesion could be found in distal segments of the coronary artery.</p><p><b>CONCLUSIONS</b>Long term follow up revealed spontaneous regression occurred in 55% of patients and development into severe coronary artery stenosis in 7%. It is necessary to perform long-term follow-up in patients with coronary artery lesions caused by Kawasaki disease. 2-D Echo can not completely replace CAG during follow-up of coronary artery lesions caused by Kawasaki disease.</p>