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Markers of Endothelial Dysfunction in Kawasaki Disease: An Update
Rajni Kumrah1, Taru Goyal1, Amit Rawat2
1Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Kawasaki disease (KD) involves coronary artery issues, with endothelial dysfunction (ED) playing a key role. Identifying laboratory markers for ED could help monitor KD and predict long-term cardiovascular risks.
Area of Science:
- Pediatrics
- Cardiology
- Immunology
Background:
- Kawasaki disease (KD) is a vasculitis affecting medium vessels, particularly coronary arteries.
- Cardiovascular complications like coronary artery abnormalities (CAAs) and myocarditis are significant concerns in KD.
- Endothelial dysfunction (ED) is increasingly recognized as central to KD pathogenesis and CAA development.
Purpose of the Study:
- To review the current understanding of endothelial dysfunction (ED) in Kawasaki disease (KD).
- To highlight the need for laboratory markers to evaluate ED in KD.
- To explore potential biomarkers for ED in KD, including oxidative stress markers, circulating cells, and inflammatory mediators.
Main Methods:
- Literature review focusing on endothelial dysfunction in Kawasaki disease.
- Analysis of existing clinical parameters used to assess ED.
- Identification and categorization of potential laboratory biomarkers for ED.
Main Results:
- Endothelial dysfunction (ED) is a critical factor in Kawasaki disease (KD) pathogenesis.
- Current evaluation of ED in KD relies on limited clinical parameters.
- Several categories of laboratory biomarkers, including oxidative stress markers, cytokines, and adhesion molecules, show promise for assessing ED in KD.
Conclusions:
- Validated laboratory biomarkers for ED could significantly aid in monitoring KD disease course.
- These biomarkers may offer predictive value for long-term risks such as premature atherosclerosis in KD patients.
- Further multicentric studies are needed to validate these potential biomarkers for clinical use in KD management.
Abstract:
Kawasaki disease (KD) is a medium vessel vasculitis that has a special predilection for coronary arteries. Cardiovascular complications include the development of coronary artery abnormalities (CAAs) and myocarditis. Endothelial dysfunction (ED) is now recognized to be a key component in the pathogenesis of KD and is believed to contribute to the development of CAAs. ED has been evaluated by several clinical parameters. However, there is paucity of literature on laboratory markers for ED in KD. The evaluation of ED can be aided by the identification of biomarkers such as oxidative stress markers, circulating cells and their progenitors, angiogenesis factors, cytokines, chemokines, cell-adhesion molecules, and adipokines. If validated in multicentric studies, these biomarkers may be useful for monitoring the disease course of KD. They may also provide a useful predictive marker for the development of premature atherosclerosis that is often a concern during long-term follow-up of KD. This review provides insights into the current understanding of the significance of ED in KD.
