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Elevated Inducible Nitric Oxide Levels and Decreased Hydrogen Sulfide Levels Can Predict the Risk of Coronary Artery Ectasia in Kawasaki Disease

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Abstract

Kawasaki disease (KD) is a vasculitis disease in children that is associated with coronary artery ectasia (CAE). We investigated whether inducible nitric oxide synthase (i-NOS) and hydrogen sulfide (H2S) could be used to predict CAE secondary to KD. We enrolled 65 children with KD (35 cases with CAE and 30 cases without CAE), 33 healthy children, and 32 children with fever but without vasculitis disease (febrile group). We measured plasma nitric oxide (NO), total nitric oxide synthase (Total-NOS), i-NOS, constructive nitric oxide synthase (c-NOS) levels, and H2S content in all patients. Plasma NO, Total-NOS, i-NOS, and H2S were higher in KD children than in healthy and febrile children (P < 0.05). The i-NOS level was higher in KD children with CAE compared to those without CAE, while the H2S was lower (both P < 0.05). Using a combination of i-NOS (higher than 10 U/mL) and H2S (lower than 3.31 μmol/L) to predict CAE had 80 % sensitivity and 81 % specificity (P < 0.05). Elevated plasma i-NOS and decreased plasma H2S levels in the acute phase of KD have good predictive value for CAE and may be used to guide appropriate clinical treatment and prevent future cardiovascular complications.

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Abbreviations

AUC:

Area under the curve

CAE:

Coronary artery ectasia

CBS:

Cystathionine-β-synthase

CSE:

Cystathionine-γ-lyase

c-NOS:

Constructive nitric oxide synthase

EDTA:

Ethylenediamine tetraacetic acid

H2S:

Hydrogen sulfide

i-NOS:

Inducible nitric oxide synthase

KD:

Kawasaki disease

LPS:

Lipopolysaccharide

NaHS:

Sodium hydrosulfide

NO:

Nitric oxide

NOS:

Nitric oxide synthase

O2 − :

Superoxide anion

OH:

Hydroxyl radical

ROC:

Receiver operating characteristic curve

Total-NOS:

Total nitric oxide synthase

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Acknowledgments

This study was funded by the science foundation for Beijing Scientific Research and Technology Project (Z131100006813024), which was given to Guiying Liu.

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Authors and Affiliations

  1. Department of Cardiovascular Diseases, Children’s Hospital Affiliated to Capital Institute of Pediatrics, No.2 Ya-Bao Road, ChaoYang District, Beijing, 100020, China

    Ruixia Song & Xiaohui Li

  2. Department of Pediatrics, Beijing Anzhen Hospital, No.2 An-zhen Road, ChaoYang District, Beijing, 100029, China

    Guiying Liu & Wenya Xu

  3. Department of Pediatrics, Peking University First Hospital, No.8 Xishenku Street, Xi Cheng District, Beijing, 100034, China

    Jia Liu & Hongfang Jin

Authors
  1. Ruixia Song
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  2. Guiying Liu
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  3. Xiaohui Li
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  4. Wenya Xu
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  5. Jia Liu
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  6. Hongfang Jin
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Corresponding authors

Correspondence to Guiying Liu or Xiaohui Li.

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The authors declare that they have no conflict of interest.

Ethical Approval

This research had acquired the approval from the Ethics Committee of Beijing Anzhen Hospital, China. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Before the experiment, informed consent from each patients’ parent or guardian was obtained.

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Song, R., Liu, G., Li, X. et al. Elevated Inducible Nitric Oxide Levels and Decreased Hydrogen Sulfide Levels Can Predict the Risk of Coronary Artery Ectasia in Kawasaki Disease. Pediatr Cardiol 37, 322–329 (2016). https://doi.org/10.1007/s00246-015-1280-8

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  • DOI: https://doi.org/10.1007/s00246-015-1280-8

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