Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
J Chin Med Assoc. 2013 Aug;76(8):438-45. doi: 10.1016/j.jcma.2013.04.005. Epub 2013 Jun 13.
Interleukin-18 (IL-18) plays an important role in mediating cytokine cascade leading to coronary artery lesions (CALs) in Kawasaki disease (KD). However, our research suggested that the literature regarding IL-18 and KD is limited. Consequently, this study aimed to evaluate the correlation between IL-18 and CALs in patients with KD.
In this prospective study of 14 children with KD (seven without and seven with CALs in the acute phase), we obtained patient measurements of a series of serum IL-18 levels in the acute, subacute, and convalescent phases. Serum IL-18 levels were measured with a Bio-Plex cytokine assay. Control samples were obtained from 18 febrile children with viral infection.
Compared with febrile controls, patients with acute-stage CALs [postintravenous immunoglobulin (post-IVIG) period] had a significantly higher IL-18 level (88.4 ± 20.7 vs 56.0 ± 35.0 pg/mL, p = 0.006). However, those without acute-stage CALs (post-IVIG period) lacked similarly elevated IL-18 level readings (62.0 ± 40.6 vs 56.0 ± 35.0 pg/mL, p = 0.762). The IL-18 level of patients with acute-stage CALs did not decrease significantly until the convalescent phase (97.4 ± 55.8 vs 38.7 ± 22.6 pg/mL, p = 0.018), but for those without CALs, it decreased significantly in the subacute phase (60.2 ± 37.4 vs 23.6 ± 13.8 pg/mL, p = 0.018). In the subacute stage, there was a significant difference of IL-18 level between patients with and without acute-stage CALs (p = 0.048).
Our data show that IL-18 levels were elevated in the acute phase of KD and might be related to the formation of CALs.
白细胞介素-18（IL-18）在介导细胞因子级联反应导致川崎病（KD）冠状动脉损伤（CALs）中发挥重要作用。然而，我们的研究表明，关于 IL-18 和 KD 的文献有限。因此，本研究旨在评估 IL-18 与 KD 患者 CALs 的相关性。
在这项对 14 名川崎病患儿（急性期无 CALs7 例，有 CALs7 例）的前瞻性研究中，我们获得了患者在急性期、亚急性期和恢复期一系列血清 IL-18 水平的测量值。使用 Bio-Plex 细胞因子分析测定血清 IL-18 水平。对照样本取自 18 例病毒性感染发热儿童。
与发热对照组相比，急性期伴有 CALs 的患儿[静脉注射免疫球蛋白（post-IVIG）后]的 IL-18 水平显著升高（88.4 ± 20.7 vs. 56.0 ± 35.0 pg/mL，p = 0.006）。然而，那些急性期无 CALs（post-IVIG 后）的患儿缺乏类似升高的 IL-18 水平（62.0 ± 40.6 vs. 56.0 ± 35.0 pg/mL，p = 0.762）。急性期伴有 CALs 的患儿的 IL-18 水平直到恢复期才明显下降（97.4 ± 55.8 vs. 38.7 ± 22.6 pg/mL，p = 0.018），但无 CALs 的患儿在亚急性期明显下降（60.2 ± 37.4 vs. 23.6 ± 13.8 pg/mL，p = 0.018）。在亚急性期，伴有和不伴有急性期 CALs 的患儿之间的 IL-18 水平存在显著差异（p = 0.048）。
我们的数据表明，IL-18 水平在 KD 的急性期升高，可能与 CALs 的形成有关。
