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川崎病基因多态性与静脉注射免疫球蛋白治疗反应的相关性研究。

Association of Genetic Polymorphisms in Kawasaki Disease with the Response to Intravenous Immunoglobulin Therapy.

机构信息

Second Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloníki, Greece.

出版信息

Pediatr Cardiol. 2023 Jan;44(1):1-12. doi: 10.1007/s00246-022-02973-2. Epub 2022 Jul 30.

Abstract

Kawasaki disease (KD) is an acute febrile and systemic vasculitis disease mainly affecting children < 5 years old. Although the first case of KD was reported in 1967 and despite extensive research on KD since then, the cause of the disease remains largely unknown. The most common complications of KD are coronary artery lesions (CAL), which significantly increase the risk of coronary heart disease. The standard treatment for KD is high-dose intravenous immunoglobulin (IVIG) plus aspirin within 10 days from symptoms' appearance, which has been shown to decrease the incidence of CAL to 5-7%. Despite the benefits of IVIG, about 25% of the patients treated with IVIG develop resistance or are unresponsive to the therapy, which represents an important risk factor for CAL development. The cause of IVIG unresponsiveness has not been fully elucidated. However, the role of gene polymorphisms in IVIG response has been suggested. Herein, we comprehensively review genetic polymorphisms in KD that have been associated with IVIG resistance/unresponsiveness and further discuss available models to predict IVIG unresponsiveness.Kindly check and confirm inserted city in affiliation [1] is correctly identified.confirm.

摘要

川崎病(KD)是一种主要影响<5 岁儿童的急性发热性全身性血管炎疾病。尽管 1967 年首次报道了首例 KD 病例,并且此后对 KD 进行了广泛的研究,但该病的病因仍很大程度上未知。KD 的最常见并发症是冠状动脉病变(CAL),这大大增加了患冠心病的风险。KD 的标准治疗是在症状出现后 10 天内使用大剂量静脉注射免疫球蛋白(IVIG)加阿司匹林,已证明这可将 CAL 的发生率降低至 5-7%。尽管 IVIG 有疗效,但约 25%接受 IVIG 治疗的患者出现耐药或对治疗无反应,这是 CAL 发展的一个重要危险因素。IVIG 无反应的原因尚未完全阐明。然而,基因多态性在 IVIG 反应中的作用已被提出。本文我们全面综述了与 IVIG 耐药/无反应相关的 KD 遗传多态性,并进一步讨论了现有的预测 IVIG 无反应的模型。请检查并确认[1]中的隶属关系插入城市是否正确识别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ba1/9978270/b28eb899b21d/246_2023_3110_Figb_HTML.jpg

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