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Objective To investigate the expression changes of myeloid-related protein-8 (MRP-8) and myeloid-related protein-14 (MRP-14) in children with Kawasaki disease (KD) and to obtain laboratory diagnostic serum markers and new targets for its drug therapy.Methods A total of 46 patients with KD(KD group) were enrolled from Jul.2009 to Dec.2010 and divided into the coronary artery dilatation(CAD) group(n =15) and the normal coronary artery group(n =31) ;Meanwhile,25 febrile patients with acute respiratory tract infection but without disease in the circulatory,blood,immune systems formed the non-KD febrile group.Twenty healthy children from the out-patient department formed the healthy control group.Peripheral venous blood was collected in the acute and subacute stage of KD.Levels of MRP-8/MRP-14 were detected with enzyme-linked immunosorbnent assay (ELISA).Gene expressions of MRP-8,MRP-14 in leukocytes were analyzed by semi-quantitative reverse transcription-polymerase chain reaction(RTPCR).Results The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in the leukocytes in the out-patient acute and subacute stage of KD were significantly higher than those in the non-KD febrile group and the healthy control group(all P ＜ 0.05) ;There was no significant difference between non-KD febrile group and healthy control group (P ＞ 0.05).The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in leukocyte in actue stage of KD were significantly higher than those in subacute stage(all P ＜ 0.001).The serum levels of MRP-8/MRP-14 as well as mRNA expressions of MRP-8 and MRP-14 in the acute and the subacute stage of CAD group were significantly higher than those in the normal coronary artery group(P ＜ 0.05).Conclusions MRP-8/MRP-14 may probably play a role in the pathogenesis of KD and can be used as a diagnostic indicator for KD;MRP-8/MRP-14 may be involved in the formation of coronary artery lesion and can be used as an effective predictor for the coronary artery lesion.
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PURPOSE: To evaluate the predictable factors for why initial intravenous immune globulin(IVIG) therapy failed and the outcome of coronary lesions after additional IVIG retreated in initial IVIG-resistant Kawasaki disease(KD). METHODS: Retrospective studies were performed on 284 cases of KD treated with one episode of high-dose IVIG and 63 cases with additional IVIG retreatment at this hospital from January 2000 to June 2003. 2D echocardiogram was done at admission, two months later and every two or three months when coronary lesion had improved more than two months later. RESULTS: In 69(24.3%) of 284 cases with post-first course of IVIG therapy, 19(43.2%) of 63 cases with additional IVIG retreatment, coronary abnormality had been shown by initial 2D-echocardiogram examined at acute stage. In five(1.8%) of 284 patients with post-first course of IVIG therapy, and in three(4.8%) of 63 cases with additional IVIG retreatment, coronary lesions still remained at follow-up echocardiogram. Even though there was a tendency of increased coronary lesions in the group with additional IVIG retreatment, there was no significant differences in the incidence of coronary lesions between the two groups. There were no significant differences in age, sex, and other clinical findings between the two groups. CONCLUSION: Combination therapy with high doses of IVIG and aspirin is generally effective as a standard treatment for KD but not always. Coronary lesion did not increased despite additional IVIG therapy for initial IVIG-resistant KD. There was no predictable factor for initial IVIG-resistant KD.