Tang Bin, Lo Hang Hong, Lei Cheng, U Ka In, Hsiao Wen-Luan Wendy, Guo Xiaoling, Bai Jun, Wong Vincent Kam-Wai, Law Betty Yuen-Kwan
State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.
Department of Pediatrics, Kiang Wu Hospital, Macau SAR, China.
Phytomedicine. 2020 Apr 15;70:153208. doi: 10.1016/j.phymed.2020.153208. Epub 2020 Mar 18.
Kawasaki disease (KD) is a self-limiting acute systemic vasculitis occur mainly in infants and young children under 5 years old. Although the use of acetylsalicylic acid (AAS) in combination with intravenous immunoglobulin (IVIG) remains the standard therapy to KD, the etiology, genetic susceptibility genes and pathogenic factors of KD are still un-elucidated.
Current obstacles in the treatment of KD include the lack of standard clinical and genetic markers for early diagnosis, possible severe side effect of AAS (Reye's syndrome), and the refractory KD cases with resistance to IVIG therapy, therefore, this review has focused on introducing the current advances in the identification of genetic susceptibility genes, environmental factors, diagnostic markers and adjuvant pharmacological intervention for KD.
With an overall update in the development of KD from different aspects, our current bioinformatics data has suggested CASP3, CD40 and TLR4 as the possible pathogenic factors or diagnostic markers of KD. Besides, a list of herbal medicines which may work as the adjunct therapy for KD via targeting different proposed molecular targets of KD have also been summarized.
With the aid of modern pharmacological research and technology, it is anticipated that novel therapeutic remedies, especially active herbal chemicals targeting precise clinical markers of KD could be developed for accurate diagnosis and treatment of the disease.
川崎病(KD)是一种主要发生在5岁以下婴幼儿的自限性急性全身性血管炎。尽管阿司匹林(AAS)联合静脉注射免疫球蛋白(IVIG)仍是KD的标准治疗方法,但KD的病因、遗传易感基因和致病因素仍未阐明。
KD治疗目前面临的障碍包括缺乏用于早期诊断的标准临床和遗传标志物、AAS可能产生的严重副作用(瑞氏综合征)以及对IVIG治疗耐药的难治性KD病例,因此,本综述重点介绍了KD遗传易感基因、环境因素、诊断标志物和辅助药物干预识别方面的当前进展。
随着从不同方面对KD研究进展的全面更新,我们目前的生物信息学数据表明半胱天冬酶3(CASP3)、肿瘤坏死因子受体超家族成员40(CD40)和Toll样受体4(TLR4)可能是KD的致病因素或诊断标志物。此外,还总结了一系列可能通过针对KD提出的不同分子靶点作为KD辅助治疗的草药。
借助现代药理学研究和技术,预计可以开发出新型治疗药物,特别是针对KD精确临床标志物的活性草药化学成分,用于该疾病的准确诊断和治疗。