[HTML][HTML] Global gene expression profiling identifies new therapeutic targets in acute Kawasaki disease
Genome medicine, 2014•Springer
Background Global gene expression profiling can provide insight into the underlying
pathophysiology of disease processes. Kawasaki disease (KD) is an acute, self-limited
vasculitis whose etiology remains unknown. Although the clinical illness shares certain
features with other pediatric infectious diseases, the occurrence of coronary artery
aneurysms in 25% of untreated patients is unique to KD. Methods To gain further insight into
the molecular mechanisms underlying KD, we investigated the acute and convalescent …
pathophysiology of disease processes. Kawasaki disease (KD) is an acute, self-limited
vasculitis whose etiology remains unknown. Although the clinical illness shares certain
features with other pediatric infectious diseases, the occurrence of coronary artery
aneurysms in 25% of untreated patients is unique to KD. Methods To gain further insight into
the molecular mechanisms underlying KD, we investigated the acute and convalescent …
Background
Global gene expression profiling can provide insight into the underlying pathophysiology of disease processes. Kawasaki disease (KD) is an acute, self-limited vasculitis whose etiology remains unknown. Although the clinical illness shares certain features with other pediatric infectious diseases, the occurrence of coronary artery aneurysms in 25% of untreated patients is unique to KD.
Methods
To gain further insight into the molecular mechanisms underlying KD, we investigated the acute and convalescent whole blood transcriptional profiles of 146 KD subjects and compared them with the transcriptional profiles of pediatric patients with confirmed bacterial or viral infection, and with healthy control children. We also investigated the transcript abundance in patients with different intravenous immunoglobulin treatment responses and different coronary artery outcomes.
Results
The overwhelming signature for acute KD involved signaling pathways of the innate immune system. Comparison with other acute pediatric infections highlighted the importance of pathways involved in cell motility including paxillin, relaxin, actin, integrins, and matrix metalloproteinases. Most importantly, the IL1β pathway was identified as a potential therapeutic target.
Conclusion
Our study revealed the importance of the IL-1 signaling pathway and a prominent signature of innate immunity and cell migration in the acute phase of the illness.
Springer