Chu Hsiao-Wen, Lin Chien-Heng, Lin Ming-Chih, Hsu Ya-Chi
Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Front Pediatr. 2021 May 14;9:659598. doi: 10.3389/fped.2021.659598. eCollection 2021.
Genetic susceptibility and immune dysregulation play important roles in the pathogenesis of Kawasaki disease (KD). However, it is still unclear whether KD causes immune disorder later in life or whether inherited susceptibility to immune disorders causes KD. The aim of this study was to elucidate whether inherited immune disease properties from mothers increase the risk of KD from a population-based perspective. Taiwan's National Health Insurance Research Database was the main data source in this study. Parents and children were linked using the Taiwan Maternal and Child Health Database. Patients diagnosed with KD and younger than 18 years from 2004 to 2015 were enrolled as the study population. The control group was randomly selected from individuals without the diagnosis of KD matched by age, index year, sex, and urbanization level at a ratio of 1 to 10. The prevalence of maternal autoimmune and allergic diseases was compared between groups. In total, 7,178 children were found to have been diagnosed with Kawasaki disease. Then 71,780 children matched by index year, gender, and urbanization were randomly selected to serve as the control group. Children born from mothers with asthma and allergic rhinitis had a higher risk of developing KD. Children of mothers with an autoimmune disorder had a significantly increased tendency to develop KD. Maternal numbers of autoimmune disorders showed a dose-dependent relationship with KD incidence. This is the first population-based study to investigate maternal immune diseases and the risk of KD in their children. Children of mothers with immune disorders tend to have a higher risk of KD.
遗传易感性和免疫失调在川崎病(KD)的发病机制中起重要作用。然而,KD是否会导致日后生活中的免疫紊乱,或者免疫紊乱的遗传易感性是否会导致KD,目前仍不清楚。本研究的目的是从基于人群的角度阐明母亲遗传的免疫疾病特性是否会增加KD的风险。台湾全民健康保险研究数据库是本研究的主要数据源。利用台湾妇幼健康数据库将父母与子女进行关联。将2004年至2015年诊断为KD且年龄小于18岁的患者纳入研究人群。对照组从未诊断为KD的个体中随机选取,按照年龄、索引年份、性别和城市化水平以1:10的比例进行匹配。比较两组中母亲自身免疫性疾病和过敏性疾病的患病率。总共发现7178名儿童被诊断为川崎病。然后随机选取71780名按索引年份、性别和城市化匹配的儿童作为对照组。母亲患有哮喘和过敏性鼻炎的儿童患KD的风险更高。患有自身免疫性疾病母亲的孩子患KD的倾向显著增加。母亲自身免疫性疾病的数量与KD发病率呈剂量依赖关系。这是第一项基于人群的研究,旨在调查母亲的免疫疾病及其子女患KD的风险。患有免疫疾病母亲的孩子患KD的风险往往更高。