Studies On Expression Of INOS And Correlative Chemokines In PBMC Of Patients With Kawasaki Disease

Objective To explore the effect of NO/iNOS, SDF-1α /CXCR4 and MCP-1 in Kawasaki Disease and their relationship during the development of KD. Methods Plasma (NO₃^- +NO₂^- ) concentration, SDF-1α concentration and MCP-1 concentration were measured by ELISA (enzyme-linked immunosorbent assay), and iNOS mRNA expression, CXCR4 mRNA expression, MCP-1 mRNA expression in PBMC were measured by qRT-PCR (quantitative Reverse Transcriptase Polymerase Chain Reaction) in comparison of four groups: (1)56 patients with KD,(2)60 cases age-matched non-infective patients(3)66 cases age-matched febrile patients with various diseases and 35 cases age-matched patients with HSP as a control group, respectively. Results 1. Plasma (NO+3^- + NO₂^-) concentration and iNOS mRNA expression of PBMC in patients with inactive KD were lower than those of patients with active KD, but they were higher than those of control groups . In acute KD period, there was an remarkble increase in plasma (NO₃^- + NO₂^- ) concentration and iNOS mRNA expression of PBMC in patients with coronary artery lesions than those in patients without coronary artery lesions. 2. Plasma SDF-1α concentration in patients with inactive/active KD were higher than those of control group. There were no significant differences between KD patients with coronary artery lesions and KD patients without coronary artery lesions. 3. CXCR4 mRNA expression in PBMC: There was marked increase in patients with active KD than those of control groups. And same increase in patients with inactive KD than those of non-infective patients and patients with HSP, but there were no significant differences between inactive KD and febrile patients. In acute KD period there was marked increase in patients with coronary artery lesions than those in patients without coronary artery lesions. 4. Plasma MCP-1 concentration and MCP-1 mRNA expression in PBMC of patients with active KD were higher than those of control group. There was marked increase in patients with inactive KD than those of non-infective patients and patients with HSP, but there were no significant differences between inactive KD and febrile patients. There was marked increase in KD patients with coronary artery lesions than those in patients without coronary artery lesions. Conclusion 1. Plasma (NO₃^- + NO₂^-)concentration and iNOS mRNA expression in PBMC were significantly increased in patients with KD, and they were higher in KD with coronary artery lesions. It suggests that NO/iNOS may involve in the pathogenesis of KD and the coronary complication. 2. Plasma SDF-1α concentration and CXCR4 mRNA expression in PBMC were significantly increased in patients with acute KD, but they showed no significant differences between KD patients with coronary artery lesions and those without coronary artery lesions. It suggests that SDF-1α /CXCR4 may not be a key element of corronary artery lesions in KD. 3. Plasma MCP-1 concentration and MCP-1 mRNA expression in PBMC were significantly increased in patients with KD, and they were higher in KD with coronary artery lesions. It indicates that MCP-1 may be a useful parameter for monitoring disease active in patients with KD.