Falcini F, Cerinic M M, Ermini M, Generini S, Lombardi A, Pignone A, Leoncini G, Tirassa P, Aloe L
Department of Pediatrics, University of Florence, Italy.
J Rheumatol. 1996 Oct;23(10):1798-802.
To investigate the serum levels of nerve growth factor (NGF) and their possible relationship with disease activity in Kawasaki disease.
Twelve children with Kawasaki disease, 12 healthy children (afebrile controls), and 12 children with high fever related to upper respiratory tract viral infections (URTVI) were enrolled in the study. Serum NGF levels were measured by an ELISA method before and after therapy. In addition, angiotensin converting enzyme (ACE), and erythrocyte sedimentation rate (ESR), complete hemochrome, and C-reactive protein were tested as indicators of endothelial injury and disease activity, respectively.
NGF levels were strikingly increased in the acute phase of Kawasaki disease (1219.54 +/- 1660.29 pg/ml) and decreased in the inactive phase of the disease (277.08 +/- 245.64 pg/ml), while remaining significantly higher than controls (6.5 +/- 2.03 pg/ml). In febrile patients with URTVI, NGF levels (30.18 +/- 44.70 pg/ml) were moderately but significantly increased compared to afebrile controls, but remarkably lower in respect to active and inactive Kawasaki disease. In active Kawasaki disease, ACE values were significantly lower than in healthy children (2.8 +/- 1.7 vs 10.1 +/- 4.2 pmol/ml/min; p < 0.001) and increased during the inactive phase, but remaining lower than in controls (4.8 +/- 2.7 pmol/ml/min); ESR, hemoglobin level, and platelet count showed significant correlation with NGF, while ACE levels showed a significant inverse correlation with ESR and NGF.
In Kawasaki disease, NGF increased together with decreased ACE may be linked to a diffuse vascular inflammatory process. NGF and ACE levels remained abnormal even when there was no clinical sign of disease activity. This may indicate that the disease process is not in complete remission and suggests careful and prolonged cardiac followup until their normalization.
研究川崎病患者血清神经生长因子（NGF）水平及其与疾病活动度的可能关系。
本研究纳入12例川崎病患儿、12例健康儿童（无发热对照）和12例与上呼吸道病毒感染（URTVI）相关的高热患儿。采用酶联免疫吸附测定（ELISA）法在治疗前后检测血清NGF水平。此外，分别检测血管紧张素转换酶（ACE）、红细胞沉降率（ESR）、全血细胞计数和C反应蛋白作为内皮损伤和疾病活动度的指标。
川崎病急性期NGF水平显著升高（1219.54±1660.29 pg/ml），疾病非活动期降低（277.08±245.64 pg/ml），但仍显著高于对照组（6.5±2.03 pg/ml）。在URTVI发热患者中，NGF水平（30.18±44.70 pg/ml）与无发热对照相比有中度但显著升高，但与川崎病活动期和非活动期相比显著降低。在川崎病活动期，ACE值显著低于健康儿童（2.8±1.7 vs 10.1±4.2 pmol/ml/min；p<0.001），在非活动期升高，但仍低于对照组（4.8±2.7 pmol/ml/min）；ESR、血红蛋白水平和血小板计数与NGF呈显著相关，而ACE水平与ESR和NGF呈显著负相关。
在川崎病中，NGF升高伴ACE降低可能与弥漫性血管炎症过程有关。即使没有疾病活动的临床体征，NGF和ACE水平仍异常。这可能表明疾病过程未完全缓解，提示应进行仔细且长期的心脏随访直至其恢复正常。
