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Angiogenesis in Fatal Acute Kawasaki Disease Coronary Artery and Myocardium

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Abstract

Angiogenesis has been shown to be dysregulated in coronary artery (CA) aneurysms in the chronic phase of Kawasaki disease (KD). Neovascularization may occur in inflammatory-related vascular diseases because many angiogenesis mediators are secreted by inflammatory cells. We hypothesized that inflammation of the acute KD CA aneurysm could lead to dysregulation of angiogenesis mediators and subsequent neovascularization. To investigate this hypothesis, acute fatal KD cardiac tissues were immunostained for angiogenic inducers and inhibitors. Microvessel density was determined and the degree of inflammation assessed. Marked inflammation and angiogenesis were found in acute KD CA aneurysms and myocardium, with the highest microvessel density seen in patients who died 2–3 weeks after onset of the disease. Expression of proangiogenic proteins was higher than expression of inhibitors in KD CA aneurysms and myocardium. Angiogenesis mediators were localized to inflammatory cells in the myointima, adventitia, and myocardium. We conclude that significant neovascularization occurs in acute KD CA aneurysms and myocardium much sooner after onset of the disease than has been previously reported, that multiple angiogenesis factors are involved, and that dysregulation of angiogenesis likely contributes to KD vasculopathy.

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Acknowledgments

This work was supported by the Pediatric Infectious Disease Society Fellowship funded by Lilly Research Laboratories (to A.F.), to NIH grants HL63771 and HL67011 (to A.H.R.), and NIH grants CA064239 and CA095301 (to S.E.C.)

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Authors and Affiliations

  1. Department of Pediatrics, Northwestern University, Feinberg School of Medicine, W140, Ward 12-204, 303 E. Chicago Ave, Chicago, IL, 60611, USA

    A.F. Freeman, F.L. Garcia & A.H. Rowley

  2. Department of Pathology-W127, Northwestern University, Feinberg School of Medicine, 303E. Chicago Ave, Chicago, IL, 60611, USA

    S.E. Crawford & M.L. Cornwall

  3. Division of Infectious Diseases, Children’s Memorial Hospital, 2300 Children’s Plaza, Chicago, IL, 60614, USA

    S.T. Shulman

Authors
  1. A.F. Freeman
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  2. S.E. Crawford
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  3. M.L. Cornwall
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  4. F.L. Garcia
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  5. S.T. Shulman
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  6. A.H. Rowley
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Corresponding author

Correspondence to A.F. Freeman.

Additional information

Presented in poster formats at the Pediatric Academic Society’s annual conference 5/04 in San Francisco, CA, USA May 2003

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Freeman, A., Crawford, S., Cornwall, M. et al. Angiogenesis in Fatal Acute Kawasaki Disease Coronary Artery and Myocardium. Pediatr Cardiol 26, 578–584 (2005). https://doi.org/10.1007/s00246-005-0801-2

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  • DOI: https://doi.org/10.1007/s00246-005-0801-2

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