Liu Xingzhu, Chen Yanfei, Yang Yanfei, Su Zhongjian, Wang Feng, Zhanghuang Chenghao, Wu Yuqin, Zhang Xing
Department of Special Needs Ward, Kunming Children's Hospital, Kunming, Yunnan, China.
Department of Cardiology, Kunming Children's Hospital, Kunming, Yunnan, China.
Front Med (Lausanne). 2023 Jul 27;10:1193303. doi: 10.3389/fmed.2023.1193303. eCollection 2023.
To investigate the correlation between gene polymorphisms and coronary artery lesion in Kawasaki disease.
Two hundred and thirty four children with Kawasaki disease (KD group), 200 healthy children (normal group) and 208 children with non-KD fever (fever group) were enrolled. General clinical indicators, the concentration of serum MMPs, TIMP-1, FG-α,fibrinogen level, molecular function (FMPV/ODmax) and Thr312Ala polymorphism were detected individually by testing peripheral venous blood after fasting in the morning.
There was no significant difference in average age among the three groups, which were 3.03 ± 1.22 years, 3.17 ± 1.30 years, and 3.21 ± 1.31 years, respectively. Compared with those in the fever group, the levels of white blood cell count (WBC), platelet count (PLT), procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and fibrinogen (Fg) levels were significantly increased in the KD group. Red blood cell count (RBC) and hemoglobin (Hb) levels were significantly decreased ( < 0.05).The concentration of serum MMPs, TIMP-1, and FG-α in the KD and fever groups were significantly higher than those in the normal group ( < 0.05). The concentration of MMP-2, MMP-3, MMP-9, MMP-13, TIMP-1, and FG-α in the KD group were significantly higher than those in the fever group ( < 0.05).The KD group was divided into two subgroups,55 patients with combined CAL and 179 patients without combined CAL. The plasma fibrinogen concentration in the combined CAL group was significantly higher than that in the non-combined CAL and normal groups ( < 0.01). There was no statistically significant difference in FMPV/ODmax among the three groups ( > 0.05). Compared with normal group, the FGA GG, GA, and AA genotype and G, A allele frequency of the FGA gene polymorphism in the KD group showed no significant difference ( > 0.05). In the KD group, the most common type in children with CAL was GA, while the most common type in children without CAL was GG.
MMPs and FG-α were significantly upregulated in KD patients. The proportion of genotype GA in children with CAL was significantly higher than that in children without CAL, suggesting that gene polymorphisms affect coronary artery lesion in children with KD.
探讨川崎病基因多态性与冠状动脉病变之间的相关性。
纳入234例川崎病患儿（KD组）、200例健康儿童（正常组）和208例非KD发热儿童（发热组）。于清晨空腹抽取外周静脉血，分别检测一般临床指标、血清基质金属蛋白酶（MMPs）、基质金属蛋白酶组织抑制因子-1（TIMP-1）、成纤维细胞生长因子-α（FG-α）、纤维蛋白原水平、分子功能（FMPV/ODmax）及Thr312Ala基因多态性。
三组患儿的平均年龄分别为3.03±1.22岁、3.17±1.30岁和3.21±1.31岁，差异无统计学意义。与发热组相比，KD组患儿的白细胞计数（WBC）、血小板计数（PLT）、降钙素原（PCT）、C反应蛋白（CRP）、红细胞沉降率（ESR）、白细胞介素-6（IL-6）、单核细胞趋化蛋白-1（MCP-1）及纤维蛋白原（Fg）水平显著升高，红细胞计数（RBC）和血红蛋白（Hb）水平显著降低（P<0.05）。KD组和发热组患儿血清MMPs, TIMP-1及FG-α浓度均显著高于正常组（P<0.05）。KD组患儿的基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶-3（MMP-3）、基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶-13（MMP-13）、TIMP-1及FG-α浓度显著高于发热组（P<0.05）。KD组分为两个亚组，55例合并冠状动脉损害（CAL）患儿和179例未合并CAL患儿。合并CAL组患儿血浆纤维蛋白原浓度显著高于未合并CAL组和正常组（P<0.01）。三组间FMPV/ODmax差异无统计学意义（P>0.05）。与正常组相比，KD组患儿FGA基因多态性的FGA GG、GA及AA基因型和G、A等位基因频率差异无统计学意义（P>0.05）。在KD组中，合并CAL患儿最常见的基因型为GA，未合并CAL患儿最常见的基因型为GG。
KD患儿MMPs及FG-α显著上调。合并CAL患儿的GA基因型比例显著高于未合并CAL患儿，提示基因多态性影响KD患儿的冠状动脉病变。
