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川崎病与过敏性疾病。

Kawasaki Disease and Allergic Diseases.

作者信息

Huang Po-Yu, Huang Ying-Hsien, Guo Mindy Ming-Huey, Chang Ling-Sai, Kuo Ho-Chang

机构信息

Department of Traditional Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Pediatrics, Kawasaki Disease Center, College of Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan.

出版信息

Front Pediatr. 2021 Jan 7;8:614386. doi: 10.3389/fped.2020.614386. eCollection 2020.

Abstract

Kawasaki disease (KD) is an inflammatory disorder with an unknown etiology. It is the leading cause of acquired heart disease, which leads to coronary vasculitis among children. Studies of frequent manifestation of allergic diseases in children with KD have been the subject of mounting clinical interest. However, evidence supporting the association between KD and allergies has yet to be systematically reviewed. In this article, we reviewed current literature regarding the association between KD and allergic diseases. References for this review were identified through searches of PubMed, Cochrane, and Embase through the end of August 2020. The results of the analyses of immune repertoire, clinical, and epidemiological studies have indicated some of the characteristics of infectious disease for KD. Although some allergic disorders, such as asthma, may be exacerbated by viral infections, allergies are typically caused by an allergen that triggers an immune response, with the potential involvement of type 2 inflammation and immune disturbances leading to tissue remodeling in genetically susceptible hosts. The effect of intravenous immunoglobulin is multi-faceted and results in a decrease in activating Fc gamma receptor IIA and an increase in anti-inflammatory eosinophils. The findings from this review demonstrate that children who have suffered from KD are more likely to have allergic rhinitis than the general population and their siblings, a condition that lasts until the age of 17. When followed up as teenagers and adults, children with KD are more likely to develop urticaria. This review supports that allergic diseases, such as allergic rhinitis, have been demonstrated to increase following KD. Therefore, the importance of allergic diseases in patients with KD should be emphasized in long-term care. Interventions that include strategies for managing allergies in children with KD would be beneficial.

摘要

川崎病(KD)是一种病因不明的炎症性疾病。它是后天性心脏病的主要病因,可导致儿童冠状动脉血管炎。对KD患儿中过敏性疾病频繁表现的研究一直是临床日益关注的主题。然而,支持KD与过敏之间关联的证据尚未得到系统综述。在本文中,我们综述了关于KD与过敏性疾病之间关联的当前文献。通过检索截至2020年8月底的PubMed、Cochrane和Embase确定了本综述的参考文献。免疫库、临床和流行病学研究的分析结果表明了KD作为传染病的一些特征。虽然某些过敏性疾病,如哮喘,可能会因病毒感染而加重,但过敏通常是由触发免疫反应的过敏原引起的,可能涉及2型炎症和免疫紊乱,导致基因易感宿主的组织重塑。静脉注射免疫球蛋白的作用是多方面的,会导致激活型Fcγ受体IIA减少和抗炎性嗜酸性粒细胞增加。本综述的结果表明,患过KD的儿童比普通人群及其兄弟姐妹更易患过敏性鼻炎,这种情况会持续到17岁。在青少年和成年人阶段进行随访时,KD患儿更易患荨麻疹。本综述支持已证明KD后过敏性疾病,如过敏性鼻炎会增加。因此,在长期护理中应强调过敏性疾病在KD患者中的重要性。包括管理KD患儿过敏策略的干预措施将是有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f605/7817814/472f67921fd4/fped-08-614386-g0001.jpg

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