Abstract
Kawasaki disease (KD) is a syndrome of systemic vasculitis of unknown etiology that is complicated by coronary artery lesions (CAL), leading occasionally to cardiac ischemic sequelae. To examine whether vascular endothelial growth factor (VEGF) is responsible for CAL in KD, we determined serum VEGF levels by ELISA and peripheral blood mononuclear cell (PBMC) and neutrophil VEGF expression by immunoblot analysis. Significantly increased levels of VEGF were demonstrated in acute KD as well as in other vasculitis syndromes (p < 0.0001). In the 10 KD patients with CAL, serum VEGF levels were maximal approximately 2 wk postonset when CAL generally develops and were significantly higher than in 20 patients without CAL (mean, 474 and 241 pg/mL, respectively;p = 0.00015). During the same period, immunoblot analysis revealed maximal VEGF expression in PBMC, corresponding to serum VEGF levels in most patients and being particularly marked in patients with CAL (p < 0.01). Neutrophils expressed VEGF only in the early stage of acute KD and declined rapidly in the majority of KD patients regardless of the presence of CAL, showing a strikingly different expression pattern than that for PBMC. Predominant VEGF expression by PBMC was also demonstrated in patients with other vasculitis syndromes and only faintly in normal controls. The results suggest that VEGF is generated dynamically in KD, presumably reflecting its disease activity. Neutrophil-derived VEGF may play a role in regulating early vascular responses, whereas PBMC-derived VEGF may contribute to later vascular injury and remodeling.
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Abbreviations
- VEGF:
-
vascular endothelial growth factor
- KD:
-
Kawasaki disease
- CAL:
-
coronary artery lesion
- PBMC:
-
peripheral blood mononuclear cell
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Acknowledgements
The authors thank Dr. Hideki Origasa for his assistance in analyzing the data and Drs. Ayumi Miyazaki, Ken Suzaki, Masayoshi Miura, Gyokei Murakami, Hiromichi Kubota, Masaharu Kasei, Kyoko Nakaaki, Youichi Onoue, Toshiko Itazawa, Kouki Saida, Tatsuya Fuchizawa, Daijirou Shima, and Eiko Kanai for their collection of blood samples from KD patients. We also thank Drs. Atsuko Suzuki and Masaru Terai for their helpful comments and suggestions, and Hitoshi Moriuchi and Chikako Sakai for their e-cellent technical assistance.
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Supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan and by grants from the Ministry of Health and Welfare of Japan. X.Y. is supported by grants from the Ministry of Education of China.
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Hamamichi, Y., Ichida, F., Yu, X. et al. Neutrophils and Mononuclear Cells Express Vascular Endothelial Growth Factor in Acute Kawasaki Disease: Its Possible Role in Progression of Coronary Artery Lesions. Pediatr Res 49, 74–80 (2001). https://doi.org/10.1203/00006450-200101000-00017
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DOI: https://doi.org/10.1203/00006450-200101000-00017
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