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Published on: January 23, 2019
Circulating endothelial cells in Kawasaki disease
K Nakatani1, S Takeshita, H Tsujimoto
1Department of Paediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan.
Insights
Circulating endothelial cells (CECs) increase in children with Kawasaki disease (KD), particularly during acute and subacute phases. Higher CEC numbers correlate with complicated coronary artery lesions in KD patients, indicating endothelial damage.
Area of Science:
- Cardiovascular Research
- Pediatric Vasculitis
- Endothelial Biology
Background:
- Circulating endothelial cells (CECs) are markers of vascular injury in various diseases.
- Kawasaki disease (KD) is a systemic vasculitis affecting children, potentially leading to coronary artery lesions (CAL).
Purpose of the Study:
- To investigate the number and origin of CECs in patients with KD.
- To determine if increased CECs are associated with complicated coronary artery lesions (CAL) in KD.
Main Methods:
- Enumeration of CECs and endothelial progenitor cells (EPCs) using immunohistochemistry with specific monoclonal antibodies.
- Comparison of CEC and EPC counts between KD patients (acute, subacute, convalescent phases) and healthy children.
- Analysis of CEC and EPC levels in KD patients with and without CAL.
Main Results:
- Mean CEC numbers were significantly elevated in acute and subacute phases of KD compared to convalescent phases and healthy controls.
- KD patients with CAL exhibited significantly higher mean CEC numbers than those without CAL.
- EPCs constituted a small percentage of total CECs, but their numbers were also significantly higher in KD patients with CAL during the subacute phase.
Conclusions:
- CEC numbers increase during active Kawasaki disease vasculitis.
- Elevated CEC and EPC levels in KD may serve as indicators of endothelial damage.
- Increased CECs and EPCs are associated with the development of complicated coronary artery lesions in Kawasaki disease.
Abstract:
Recent reports have demonstrated that circulating endothelial cells (CECs) are observed in several diseases with vascular injury. Because Kawasaki disease (KD) is one type of systemic vasculitis, we hypothesized that an increased number of CECs may be associated with the appearance of complicated coronary artery lesions (CAL). In the present study we investigated the enumeration and origin of CECs in 20 patients with KD, using an immunohistochemical method with monoclonal antibodies: clone P1H12 against ECs and clone AC133 against endothelial progenitor cells (EPCs), which were derived from the bone marrow. The mean number of CECs increased significantly (P < 0.05) from the acute through the subacute phases of KD compared with both the convalescent phase of KD and healthy children. The mean number of CECs was significantly (P < 0.05) higher in six KD patients with CAL than in 14 KD patients without CAL. The population of EPCs in the total CECs in KD was 4.4 +/- 1.2% (range 0-18%). The number of EPCs during the subacute phase was also significantly higher (P < 0.05) in KD patients with CAL than in those without CAL. Our findings indicate that the number of CECs increase in KD vasculitis and suggest that the increased numbers of CECs and EPCs may reflect the EC damage of this disease.
