Zou Qing-Mei, Li Xiao-Hui, Song Rui-Xia, Xu Nan-Ping, Zhang Ting, Zhang Ming-Ming, Lin Yao, Shi Lin, Fu Jin, Cui Xiao-Dai
Department of Cardiovascular Diseases, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
Department of Emergency, Children's Hospital of Jiangxi Province, Nanchang, Jiangxi, China.
Pediatr Res. 2015 Aug;78(2):205-11. doi: 10.1038/pr.2015.81. Epub 2015 May 4.
The mechanisms underpinning Kawasaki disease (KD) are incompletely understood. There is an unmet need for specific biomarkers for the early diagnosis of KD.
Eighty-five KD patients suffering from acute-phase and subacute-phase KD, 40 healthy children, and 40 febrile children comprised the study cohort. An enzyme-linked immunosorbent assay was used to measure plasma levels of C1q, C1q-circulating immune complex (C1q-CIC), mannan-binding lectin-associated serine protease (MASP)-1, factor B, C4d, C3d, C5a, C5b-9 and CD59.
Plasma concentrations of factor B and C5a in the acute phase were lower than those in healthy and febrile control groups (all P < 0.05). Compared with acute-phase KD patients, plasma concentrations of C1q, factor B, and C3d in KD patients were increased significantly (P < 0.05), but those of C4d, MASP-1 and CD59 decreased significantly (P < 0.05), in patients with sub-acute KD.
These data suggest that more than one pathway in the complement system is activated in KD. Importantly, decreased plasma concentrations of factor B and C5a in the acute phase (6-10 d) could be employed as biomarkers for the early diagnosis of KD.
川崎病（KD）的发病机制尚未完全明确。目前对于KD早期诊断的特异性生物标志物仍有需求。
研究队列包括85例急性期和亚急性期KD患者、40例健康儿童和40例发热儿童。采用酶联免疫吸附测定法检测血浆中C1q、C1q循环免疫复合物（C1q-CIC）、甘露聚糖结合凝集素相关丝氨酸蛋白酶（MASP）-1、B因子、C4d、C3d、C5a、C5b-9和CD59的水平。
急性期血浆B因子和C5a浓度低于健康对照组和发热对照组（均P<0.05）。与急性期KD患者相比，亚急性期KD患者血浆中C1q、B因子和C3d浓度显著升高（P<0.05），而C4d、MASP-1和CD59浓度显著降低（P<0.05）。
这些数据表明KD中补体系统不止一条途径被激活。重要的是，急性期（6-10天）血浆B因子和C5a浓度降低可作为KD早期诊断的生物标志物。
