Kawasaki Disease Center, Fukuoka Children's Hospital, 5-1-1, Kashiiteriha, Higashi-ku, Fukuoka, 813-0017, Japan.
Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishi-ku Kitakyushu-shi, Fukuoka, 807-8555, Japan.
J Microbiol Immunol Infect. 2024 Oct;57(5):691-699. doi: 10.1016/j.jmii.2024.07.001. Epub 2024 Jul 14.
BACKGROUND/PURPOSE: Recent large-scale epidemiological studies have revealed significant temporal associations between certain viral infections and the subsequent development of Kawasaki disease (KD). Despite these associations, definitive laboratory evidence linking acute or recent viral infections to KD cases remains elusive. The objective of this study is to employ a molecular epidemiological approach to investigate the temporal association between viral infections and the development of KD.
We analyzed 2460 patients who underwent the FilmArray® Respiratory Panel test between April 2020 and September 2021.
Following the application of inclusion criteria, 2402 patients were categorized into KD (n = 148), respiratory tract infection (n = 1524), and control groups (n = 730). The KD group exhibited higher positive rates for respiratory syncytial virus (RSV), human rhinovirus/enterovirus (hRV/EV), parainfluenza virus (PIV) 3, and adenovirus (AdV) compared to the control group. Additionally, coinfections involving two or more viruses were significantly more prevalent in the KD group. Notably, RSV-positive, hRV/EV-positive, and PIV3-positive KD patients exhibited a one-month delay in peak occurrence compared to non-KD patients positive for corresponding viruses. In contrast, AdV-positive KD cases did not show a one-month delay in peak occurrence. Moreover, anti-RSV, anti-PIV3, and anti-AdV antibody-positive rates or antibody titers were higher in RSV-, PIV3-, and AdV-positive KD cases, respectively, compared to non-KD cases with the same viral infections.
Recent infection with RSV, PIV3, or AdV, occasionally in conjunction with other viruses, may contribute to the pathogenesis of KD as infrequent complications.
背景/目的：最近的大规模流行病学研究表明，某些病毒感染与川崎病（KD）的后续发展之间存在显著的时间关联。尽管存在这些关联，但仍难以确定将急性或近期病毒感染与 KD 病例联系起来的确切实验室证据。本研究旨在采用分子流行病学方法研究病毒感染与 KD 发病之间的时间关联。
我们分析了 2020 年 4 月至 2021 年 9 月期间接受 FilmArray®呼吸道Panel 检测的 2460 名患者。
应用纳入标准后，将 2402 名患者分为 KD（n=148）、呼吸道感染（n=1524）和对照组（n=730）。KD 组呼吸道合胞病毒（RSV）、人鼻病毒/肠道病毒（hRV/EV）、副流感病毒（PIV）3 和腺病毒（AdV）的阳性率均高于对照组。此外，KD 组两种或多种病毒的合并感染明显更为常见。值得注意的是，与相应病毒阳性的非 KD 患者相比，RSV 阳性、hRV/EV 阳性和 PIV3 阳性的 KD 患者的发病高峰出现时间延迟了一个月。相反，AdV 阳性的 KD 病例发病高峰未出现一个月的延迟。此外，与具有相同病毒感染的非 KD 病例相比，RSV-、PIV3-和 AdV-阳性的 KD 病例的抗 RSV、抗 PIV3 和抗 AdV 抗体阳性率或抗体滴度更高。
近期感染 RSV、PIV3 或 AdV，偶尔合并其他病毒，可能导致 KD 作为不常见的并发症的发病机制。
