Assessing the role of climate and the environment as co-factors for vasculitis diseases

Kawasaki disease (kDa) has remained a medical mystery for the last five decades with a wide array of hypothesis about potential aetiological factors, that have never been confirmed. In this brief note, I revised the state-of-the-art for the so-called 'wind hypothesis', claiming that the nature and types of aerosols, particularly fine ones, can account for a central part of this research avenue and the relation to kDa. Characterizing their chemical nature, in particular of the composition in trace elements, as well as their biological components (bacteria, fungi and viruses) stands up today as the most promising avenue towards constraining the range of environmental factors modulating or being responsible for this long-debated disease. Understanding kDa thanks to its unprecedented epidemiological record in Japan, going back to before the 1970s, may also improve our understanding of other similar vasculitis and rheumatic diseases.