Nishimura Shinji, Zaitsu Masafumi, Hara Megumi, Yokota Goro, Watanabe Mamie, Ueda Yoshiaki, Imayoshi Miyoko, Ishii Eiichi, Tasaki Hakaru, Hamasaki Yuhei
Department of Pediatrics, Faculty of Medicine, Saga Medical School, and the Division of Pediatrics, Saga Prefectural Hospital Koseikan, Saga, Japan.
J Pediatr. 2003 Sep;143(3):357-62. doi: 10.1067/S0022-3476(03)00330-5.
To investigate whether a polymorphism in the CD14 gene is associated with Kawasaki disease (KD).
We extracted DNA from the whole blood of 69 control children and 67 patients with KD. We determined a polymorphism in the CD14 gene at position -159 upstream from the major transcription site (CD14/-159) by restriction fragment assay. We then investigated the association between CD14/-159 and the onset of KD and development of coronary artery lesion (CAL).
The genomic and allelic frequencies of the polymorphism were not different between normal children and KD patients. The KD patients with TT genotypes at CD14/-159 had more CAL complications than those with CT and CC (OR, 4.05; 95% CI, 1.34-12.22). The frequencies of the T allele was significantly higher than that of the C allele in KD patients with CAL (OR, 2.20; 95% CI, 1.23-3.94). Their data were confirmed in the patients whether the patients were treated with intravenous gamma-globulin. KD patients with TT genotypes had significantly higher levels of C-reactive protein and vascular endothelial growth factor, which had previously been reported as risk factors for CAL, than those with CC genotypes.
These results indicate that the T allele and TT genotype at CD14/-159 are risk factors for CAL in KD, and that the development of CAL in KD may be related to the magnitude of CD14 toll-like receptor response.
研究CD14基因多态性是否与川崎病（KD）相关。
我们从69名对照儿童和67名KD患者的全血中提取DNA。通过限制性片段分析确定主要转录位点上游-159位的CD14基因多态性（CD14 / -159）。然后我们研究了CD14 / -159与KD发病及冠状动脉病变（CAL）发展之间的关联。
正常儿童和KD患者之间该多态性的基因组和等位基因频率无差异。CD14 / -159位点TT基因型的KD患者比CT和CC基因型患者有更多的CAL并发症（比值比，4.05；95%可信区间，1.34 - 12.22）。CAL的KD患者中T等位基因频率显著高于C等位基因（比值比，2.20；95%可信区间，1.23 - 3.94）。无论患者是否接受静脉注射丙种球蛋白治疗，其数据均在患者中得到证实。TT基因型的KD患者C反应蛋白和血管内皮生长因子水平显著高于CC基因型患者，而这两种物质此前已被报道为CAL的危险因素。
这些结果表明，CD14 / -159位点的T等位基因和TT基因型是KD中CAL的危险因素，并且KD中CAL的发生可能与CD14 Toll样受体反应的强度有关。
