Platelet-Derived Microparticles: A New Index of Monitoring Platelet Activation and Inflammation in Kawasaki Disease
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To investigate the dynamic changes of platelet-derived microparticles (PDMP) in Kawasaki disease (KD) and its clinical significance and to study its relationship with intravenous immunoglobulin (IVIG) resistance, inflammatory indicators and aspirin treatment in children with KD.
Twenty children with KD were enrolled as the experimental group, while 20 age- and gender-matched children with common febrile disease were included in the control group. Blood samples were drawn before and 7–10 d after IVIG infusion and thereafter at 1, 2, and 3 mo after the onset of KD to estimate the PDMP concentrations by enzyme linked immunosorbent assay (ELISA). C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), and cytokines [Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α), and Soluble interleukin-2 (sIL-2R)] were also measured.
The level of PDMP in KD children before IVIG was significantly higher than that in controls (P < 0.0001). The PDMP level in KD children decreased significantly at 7 to 10 d after IVIG (P < 0.0001) and then decreased to the lowest level in the course of 1 to 2 mo. Some children’s PDMP level rebounded in the course of 3 mo (P = 0.047). In addition, the mean level of PDMP in IVIG-resistant children was higher than that in IVIG-effective children; however, there was no significant difference between the two groups (P = 0.1945). Furthermore, PDMP was positively correlated with hs-CRP, IL-6, and sIL-2R levels, but no correlation was observed with ESR, PCT, and TNF-α levels.
PDMP can be used as an index to monitor inflammation in children at the acute stage of KD. And the duration of platelet activation in KD is individualized.
KeywordsPlatelet-derived microparticle Platelet activation Kawasaki disease Inflammation
The authors are grateful to the participants and their parents for their commitment to this project. This study utilized clinical research facilities and resources provided by the Institute of Pediatrics in Children’s Hospital of Nanjing Medical University.
HY: Principal investigator of the project. Responsible for planning out the trial, obtaining funds, and overall conduct of the trial. He takes full responsibility for the data and their accuracy and the conduct of the research. JJ: She is responsible for performing the experiment and major proportion of writing the article. JW: Responsible for the generation of data analysis and writing of results in this article. YL: He is also responsible for performing the experiment and major proportion of writing the article. NH: She is responsible for selection of subjects and collection of blood samples. ZF: Responsible for treatment of samples. LM: Responsible for communication with parents and application for Institutional Ethics Committee. HY will act as guarantor for this paper.
Compliance with Ethical Standards
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.
Conflict of Interest
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