Changes And Clinical Significance Of Krüppel-like Factor2, Endothelial Nitric Oxide Synthase And Vascular Endothelial Growth Factor In Children With Kawasaki Disease

Objective：To explore the role of Krüppel-like factor2(KLF2), endothelial nitricoxide synthase (eNOS) and vascular endothelial growth factor (VEGF) inKawasaki disease and coronary artery lesion.Methods：48Kawasaki disease patients (13patients with coronary artery lesions,35patients without coronary artery lesions)、24febrile controls and22healthycontrols were enrolled into the study. The expression of KLF2mRNA of theperipheral blood mononuclear cells(PBMCs) were measured using real-timepolymerase chain reaction (RT-PCR),and plasma KLF2, eNOS and VEGFlevel were measured using enzyme-linked immunosorbent assay (ELISA).Results：1. The expression of KLF2mRNA of the PBMCs in patients withcoronary artery lesions is lower than those in patients without coronary arterylesions(P＜0.05) and is significantly lower than the febrile controls andnormal controls (P＜0.01). The expression of KLF2mRNA of the PBMCs inpatients without coronary artery lesions is significantly lower than the febrilecontrols and normal controls (P＜0.01). And the expression of KLF2mRNAof the PBMCs in patients with coronary artery lesions has a negativelycorrelation with Erythrocyte sedimentation rate（r=-0.609, p=0.027). 2. The plasma concentrations of KLF2in patients with coronary arterylesions is lower than those in patients without coronary artery lesions (P＜0.05) and is significantly lower than the febrile controls and normalcontrols(P＜0.01).The plasma concentrations of KLF2in patients withoutcoronary artery lesions is significantly lower than the febrile controls andnormal controls(P＜0.01). And the plasma concentrations of KLF2inCALs group has a positive correlation with serum albumin（r=0.655, p=0.021）.3.The expression of KLF2mRNA of the PBMCs has a positivecorrelation with the plasma concentrations of KLF2in KD（r=0.345, p=0.029）.4. The plasma concentrations of eNOS in patients with coronary arterylesions is lower than those in patients without coronary artery lesions (P＜0.05), and is significantly lower than the febrile controls and normal controls(P＜0.01).The plasma concentrations of eNOS in patients without coronaryartery lesions is significantly lower than the febrile controls and normalcontrols(P＜0.01).5. The plasma concentrations of VEGF in patients with coronary arterylesions is higher than those in patients without coronary artery lesions (P＜0.05), and is significantly higher than the febrile controls and normalcontrols(P＜0.01).The plasma concentrations of VEGF in patients withoutcoronary artery lesions is significantly higher than the febrile controls andnormal controls(P＜0.01).And the plasma concentrations of VEGF in thefebrile controls is higher than normal controls(P＜0.05).6. There is no correlation relationship among the expression of KLF2 mRNA of the PBMCs or the plasma concentrations of KLF2, eNOS andVEGF.Conclusion：Changes of KLF2, eNOS and VEGF may be involved in thepathogenesis of Kawasaki disease and participate in the development ofcoronary artery lesion in KD. Objective：To explore the mechanism of intravenous immunoglobulin (IVIG) in thetreatment of Kawasaki Disease and the effect of IVIG on KLF2, eNOS andVEGF in Kawasaki Disease.Methods：A total of48children with KD who received IVIG treatment wereselected in the study,22age-matched healthy children were selected as thecontrol group.The expression of KLF2mRNA of the PBMCs were measuredusing RT-PCR,and plasma KLF2, eNOS and VEGF level were measuredusing ELISA.Results：1. There is on significant difference between the expression of KLF2mRNA of PBMCs before and after IVIG treatmen（tP＞0.05）.Compare to theconvalescence group, The expression of KLF2mRNA of the PBMCs inpost-treatment is lower（P＜0.01）and the control group is higher (P＜0.05).2. There is on significant difference between the plasma concentrationsof KLF2before and after IVIG treatment （P＞0.05）. The plasmaconcentrations of KLF2in convalescence is higher than post-treatment（P＜0.05）,and is lower than control group（P＜0.05).3. The plasma concentrations of eNOS post-treatment is higher thanpre-treatment. The plasma concentrations of eNOS in convalescence is higher than post-treatment（P＜0.05）,and there is on significant difference of theplasma concentrations of eNOS in convalescence and control group（P＞0.05）.4. The plasma concentrations of VEGF post-treatment is lower thanpre-treatment （P＜0.05）. The plasma concentrations of VEGF inconvalescence is lower than post-treatment（P＜0.05）,and there is onsignificant difference of the plasma concentrations of VEGF in convalescenceand control group（P＞0.05）.Conclusion：IVIG treatment affects both the acute and convalescent of eNOS、VEGF.For KLF2, IVIG treatment plays a significant role only in convalescent stage,Increase the expression of KLF2may play an important role in the treatmentof Kawasaki disease.