Nakamura Akihiro, Ikeda Kazuyuki, Hamaoka Kenji
Central Research Laboratory, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Front Pediatr. 2019 Jun 28;7:244. doi: 10.3389/fped.2019.00244. eCollection 2019.
Kawasaki disease (KD) is a pediatric vasculitis syndrome that is often involves coronary artery lesions (e. g., coronary artery aneurysms). Although its causal factors and entire pathogenesis remain elusive, the available evidence indicates that the pathogenesis of KD is closely associated with dysregulation of immune responses to various viruses or microbes. In this short review, we address several essential aspects of the etiology of KD with respect to the immune response to infectious stimuli: 1) the role of viral infections, 2) the role of bacterial infections and the superantigen hypothesis, 3) involvement of innate immune response including pathogens/microbe-associated molecular patterns and complement pathways, and 4) the influence of genetic background on the response to infectious stimuli. Based on the clinical and experimental evidence, we discuss the possibility that a wide range of microbes and viruses could cause KD through common and distinct immune processes.
川崎病(KD)是一种小儿血管炎综合征,常累及冠状动脉病变(如冠状动脉瘤)。尽管其病因和整个发病机制仍不清楚,但现有证据表明,KD的发病机制与对各种病毒或微生物的免疫反应失调密切相关。在这篇简短的综述中,我们从对感染性刺激的免疫反应方面探讨了KD病因的几个重要方面:1)病毒感染的作用,2)细菌感染的作用和超抗原假说,3)包括病原体/微生物相关分子模式和补体途径在内的固有免疫反应的参与,以及4)遗传背景对感染性刺激反应的影响。基于临床和实验证据,我们讨论了多种微生物和病毒通过共同和独特的免疫过程导致KD的可能性。