Philip Saji, Lee Wen-Chuan, Cherian Kotturathu Mammen, Wu Mei-Hwan, Lue Hung-Chi
Department of Pediatric Cardiology, St. Gregorios Cardio-Vascular Center, Parumala, Kerala, India; Division of Biotechnology, Cardiovascular Research Centre, Animal Technology Institute, Miaoli, Taiwan.
Division of Biotechnology, Cardiovascular Research Centre, Animal Technology Institute, Miaoli, Taiwan.
Pediatr Neonatol. 2017 Aug;58(4):328-337. doi: 10.1016/j.pedneo.2016.07.007. Epub 2016 Dec 18.
Horse serum-induced immune complex coronary vasculitis in swine is the first experimental model to mimic most of the pictures of Kawasaki disease. Immune complex mechanism has been implicated as one of the possible mechanisms in the pathogenesis of vasculitis in Kawasaki disease. Antioxidants have a significant role in the reduction of cardiovascular diseases in both human and animal studies. We tried giving vitamins A, E, and C to treat immune complex vasculitis, in the hope of mitigating coronary vasculitis in Kawasaki disease.
Our study group consisted of 30 pure bred male piglets of 2-3 months of age, and they were divided into test and control groups. The test (AEC) group (n = 20) received two doses of horse serum, 10 mL (0.65 g protein)/kg body weight at 5-day intervals, and oral vitamins A, E, and C once daily for 14 days. The control group (n = 10) was further divided into the saline group (n = 3) receiving two doses of normal saline and the horse serum group (n = 7) receiving two doses of horse serum at 5-day intervals. Piglets were observed for the rashes and coronary artery dimensions.
Both the AEC and the control horse serum group developed rashes after horse serum infusions, but the AEC group developed significantly fewer rashes, and no rashes were seen in the saline group. The control horse serum group (mean ± standard deviation = 2.13 ± 0.72) showed significant coronary artery dilatation, whereas there was no significant dilatation in the AEC group (mean ± standard deviation = 0.81 ± 0.58) or the control saline group (p = 0.002).
Serum sickness is a prototype of immune complex vasculitis, and the severity can be ameliorated with antioxidants. A trial of therapeutic dosages of vitamins A, E, and C in acute phase of Kawasaki disease, may be effective in mitigation of coronary artery lesion in addition to intravenous immunoglobulin and aspirin.
猪的马血清诱导免疫复合物性冠状动脉血管炎是首个模拟大多数川崎病症状的实验模型。免疫复合物机制被认为是川崎病血管炎发病机制中的可能机制之一。在人类和动物研究中，抗氧化剂在降低心血管疾病方面具有重要作用。我们尝试给予维生素A、E和C来治疗免疫复合物性血管炎，以期减轻川崎病中的冠状动脉血管炎。
我们的研究组由30头2 - 3月龄的纯种雄性仔猪组成，它们被分为试验组和对照组。试验（AEC）组（n = 20）每隔5天接受两剂马血清，剂量为10 mL（0.65 g蛋白质）/kg体重，并连续14天每日口服维生素A、E和C。对照组（n = 10）进一步分为接受两剂生理盐水的生理盐水组（n = 3）和每隔5天接受两剂马血清的马血清组（n = 7）。观察仔猪的皮疹和冠状动脉尺寸。
AEC组和对照组马血清组在输注马血清后均出现皮疹，但AEC组出现的皮疹明显较少，生理盐水组未出现皮疹。对照组马血清组（平均值±标准差 = 2.13 ± 0.72）显示冠状动脉明显扩张，而AEC组（平均值±标准差 = 0.81 ± 0.58）或对照组生理盐水组无明显扩张（p = 0.002）。
血清病是免疫复合物性血管炎的一个典型例子，抗氧化剂可减轻其严重程度。在川崎病急性期试用维生素A、E和C的治疗剂量，除静脉注射免疫球蛋白和阿司匹林外，可能对减轻冠状动脉病变有效。
