Yoon Kyung Lim
Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Korean J Pediatr. 2015 Mar;58(3):84-8. doi: 10.3345/kjp.2015.58.3.84. Epub 2015 Mar 20.
Kawasaki disease (KD) is an acute systemic vasculitis that predominantly affects children, and can result in coronary artery lesions (CAL). A patient with KD who is resistant to treatment with intravenous immunoglobulin (IVIG) has a higher risk of developing CAL. Incomplete KD has increased in prevalence in recent years, and is another risk factor for the development of CAL. Although the pathogenesis of KD remains unclear, there has been increasing evidence for the role of genetic susceptibility to the disease since it was discovered in 1967. We retrospectively reviewed previous genetic research for known susceptibility genes in the pathogenesis of KD, IVIG resistance, and the development of CAL. This review revealed numerous potential susceptibility genes including genetic polymorphisms of ITPKC, CASP3, the transforming growth factor-β signaling pathway, B lymphoid tyrosine kinase, FCGR2A, KCNN2, and other genes, an imbalance of Th17/Treg, and a range of suggested future treatment options. The results of genetic research may improve our understanding of the pathogenesis of KD, and aid in the discovery of new treatment modalities for high-risk patients with KD.
川崎病(KD)是一种主要影响儿童的急性全身性血管炎,可导致冠状动脉病变(CAL)。对静脉注射免疫球蛋白(IVIG)治疗耐药的KD患者发生CAL的风险更高。近年来,不完全KD的患病率有所上升,这是CAL发生的另一个危险因素。尽管KD的发病机制尚不清楚,但自1967年该病被发现以来,越来越多的证据表明遗传易感性在其中发挥作用。我们回顾性地研究了以往关于KD发病机制、IVIG耐药性及CAL发生中已知易感基因的遗传研究。该综述揭示了众多潜在的易感基因,包括ITPKC、CASP3的基因多态性、转化生长因子-β信号通路、B淋巴细胞酪氨酸激酶、FCGR2A、KCNN2及其他基因,Th17/Treg失衡,以及一系列未来建议的治疗选择。遗传研究结果可能会增进我们对KD发病机制的理解,并有助于发现针对高危KD患者的新治疗方法。