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Markers of Endothelial Dysfunction in Kawasaki Disease: An Update

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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.

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Abbreviations

KD:

Kawasaki disease

CVD:

Cardiovascular disease

AHA:

American Heart Association Criteria

ITPKC:

Inositol 1,4,5-trisphosphate 3-kinase

FCGR2A:

Fc gamma receptor IIa

SNP:

Single nucleotide polymorphism

CAA:

Coronary artery aneurysms

CAD:

Coronary artery disease

CEC:

Circulating endothelial cells

EPC:

Endothelial progenitor cells

IVIg:

Intravenous immunoglobulin

FMD:

Flow-mediated dilatation

NMD:

Nitroglycerin-mediated dilatation

CiMT:

Carotid intima-media thickness

NO:

Nitric oxide

ROS:

Reactive oxygen species

ROM:

Reactive oxygen metabolites

OS:

Oxidative stress

MDA:

Malondialdehyde

MPO:

Myeloperoxidases

ADMA:

Asymmetric dimethyl arginine

EC:

Endothelial cell

TNF-ɑ:

Tumor necrosis factor-alpha

hs-CRP:

High-sensitivity C-reactive protein

LCWE:

Lactobacillus casei cell wall extract

HCAEC:

Human coronary artery endothelial cells

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Authors and Affiliations

  1. Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Rajni Kumrah, Taru Goyal, Amit Rawat & Surjit Singh

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  1. Rajni Kumrah
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  2. Taru Goyal
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  3. Amit Rawat
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  4. Surjit Singh
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Contributions

RK: data retrieval, compilation, and writing. TG: data retrieval and writing. AR: correction and editing of the manuscript. SS: review and approval of final manuscript. (Rajni Kumrah: RK; Taru Goyal: TG; Amit Rawat: AR; Surjit Singh: SS).

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Correspondence to Amit Rawat.

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Kumrah, R., Goyal, T., Rawat, A. et al. Markers of Endothelial Dysfunction in Kawasaki Disease: An Update. Clinic Rev Allerg Immunol 66, 99–111 (2024). https://doi.org/10.1007/s12016-024-08985-5

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