Change Of The Plasma Endothelial Microparticles In Children With Kawasaki Disease And The Correlation With Coronary Artery Lesions

ObjectiveEndothelial Microparticles(EMPs)are small fragments of endothelial cell membrane shed during apoptosis or activation.In recent years,the interest for endothelial cell-derived submicroscopic membranous vesicles,termed microparticles, has substantially increased,not only because of their procoagulant properties,but also because of their putative role in inflammatory processes and their ability to directly affect endothelial functions.Moreover,assays of endothelial microparticles(EMPs) have been developed as a promising new method of assessing endothelial injury to study the change in plasma endothelial microparticles in children with Kawasaki disease and the correlation with coronary artery lesions.MethodsThe participants in this study were 30 children with Kawasaki disease,including 24 children with typical Kawasaki disease and 6 ones with incomplete Kawasaki disease.All KD patients met the diagnostic criteria for KD established by the Japanese Kawasaki Disease Research Committee.Serial blood samples were obtained from all KD patients in the acute phase(before i.v.IG therapy on days1-11),in the afebrile subacute phase(after i.v.IG therapy on days 11-21)and in the convalescent phase(when C-reactive protein was negative,on days 21-60).We evaluated the presence of coronary artery lesions(CAL)using two-dimensional echocardiographic examinations.After that the KD group was divided into two groups,including patients without CAL(24 children)and with CAL(6 children).At the same time,10 children with infection and 10 healthy children as control subjects.Endothelial microparticles were measured by flow cytometry with anti-CD31 and anti-CD42.ResultsThe level of EMP in acute phase of KD is 8.18±2.29%,in subacute phase of KD is 5.93±1.05%and in convalescent phase of KD is 2.77±0.85%.The level of EMP in children with infection is 3.66±1.16%,and the ones in healthy children is 1.34±0.38%.The level of EMP was significantly higher in the acute phase than in both the convalescent phases of KD and the healthy(P＜0.01).The level of EMP was also significantly higher in the subacute phase than in the convalescent phases of KD and the healthy children(P＜0.01).The level of EMP was significantly higher in the children with infection than in the healthy children(P＜0.05).Furthermore,the level of EMP during the acute phase was also significantly higher(P＜0.01)in KD patients with CAL than in those without CAL.ConclusionThe level of the plasma EMP is increased in the acute phase and the subacute phase of KD and then decreased to the level of healthy children during the convalescent phase;The level of EMP during the acute phase was significantly higher in KD patients with CAL than in those without CAL.The plasma EMP might be useful to the diagnosis of KD and to the finding of CAL.