Serum tenascin-C as a novel predictor for risk of coronary artery lesion and resistance to intravenous immunoglobulin in Kawasaki disease—a multicenter retrospective study

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  • Okuma Yoshiaki
    Department of Pediatrics, National Center for Global Health and Medicine Course of Advanced and Specialized Medicine, Juntendo University Graduate School of Medicine
  • Suda Kenji
    Department of Pediatrics and Child Health, Kurume University School of Medicine
  • Nakaoka Hideyuki
    Department of Pediatrics, Faculty of Medicine, University of Toyama
  • Katsube Yasuhiro
    Department of Pediatrics, Nippon Medical School
  • Mitani Yoshihide
    Department of Pediatrics, Mie University Graduate School of Medicine
  • Yoshikane Yukako
    Department of Pediatrics, Faculty of Medicine, Fukuoka University
  • Ichida Fukiko
    Department of Pediatrics, Faculty of Medicine, University of Toyama
  • Matsushita Takeji
    Department of Pediatrics, National Center for Global Health and Medicine
  • Shichino Hiroyuki
    Department of Pediatrics, National Center for Global Health and Medicine Course of Advanced and Specialized Medicine, Juntendo University Graduate School of Medicine
  • Shiraishi Isao
    Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
  • Abe Jun
    Department of Allergy and Immunology, National Research Institute for Child Health and Development
  • Hiroe Michiaki
    Department of Cardiology, National Center for Global Health and Medicine
  • Yoshida Toshimichi
    Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine Mie University Research Center for Matrix Biology
  • Imanaka-Yoshida Kyoko
    Department of Pathology and Matrix Biology, Mie University Graduate School of Medicine Mie University Research Center for Matrix Biology

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タイトル別名
  • Serum Tenascin-C as a Novel Predictor for Risk of Coronary Artery Lesion and Resistance to Intravenous Immunoglobulin in Kawasaki Disease　– A Multicenter Retrospective Study –

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<p>Background:Tenascin-C (TN-C) is an extracellular matrix glycoprotein that is heavily upregulated at sites of inflammation. We conducted a retrospective study to assess the utility of TN-C as a novel biomarker to predict the risk of developing coronary artery lesions (CAL) and resistance to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD).</p><p>Methods and Results:We collected blood samples of 111 KD patients (IVIG-responder: 89, IVIG-resistant: 22; CAL: 8) and 23 healthy controls, and measured the serum levels of TN-C. TN-C levels on admission were significantly higher in patients than in healthy controls and in patients during convalescence after IVIG administration (69.6 vs. 20.4 vs. 39.7 ng/ml, respectively; P<0.001), and correlated positively with C-reactive protein (P<0.001), neutrophil (percentage; P=0.005), and ALT (P<0.001), and negatively with platelet count (P=0.023) and sodium level (P=0.025). On admission, TN-C levels in patients who later developed CAL were significantly higher than in those without CAL (P=0.010), and significantly higher in IVIG-resistant subjects than in IVIG-responders (P=0.003). The accuracy of TN-C testing for the prediction of IVIG resistance was comparable to that of the Kobayashi score.</p><p>Conclusions:Serum TN-C could be a biomarker for predicting the risk of developing CAL and IVIG resistance during the acute phase of KD. (Circ J 2016; 80: 2376–2381)</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 80 (11), 2376-2381, 2016

    一般社団法人 日本循環器学会

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