A meta-analysis of the biomarkers associated with coronary artery lesions secondary to Kawasaki disease in Chinese children

Abstract

The biomarkers associated with coronary artery lesions (CAL) secondary to Kawasaki disease (KD) in Chinese children were investigated by using Meta-analysis. We searched documents published from January 1997 to December 2009 from medical electronic databases. According to inclusion and exclusion criteria, eligible full-text papers were identified. We conducted a comprehensive quantitative analysis by using Stata10.0 statistical software package to assess the heterogeneity among the documents, calculated the summary effect and analyze publication bias and sensitivity. A total of 92 documents and 16 biomarkers were identified. All documents were case-control studies, and included 2398 patients in CAL group and 5932 patients in non-CAL (NCAL) group. The Meta-analysis showed that the levels of platelet count, platelet hematocrit (PCT), neutrophils count, platelet distribution width (PDW), mean platelet volume (MPV), erythrocyte sedimentation rate (ESR), cardiac troponin I (cTnI), and endothelin-1 (ET-1) in CAL group were significantly higher than those in NCAL group, and serum albumin (Alb) and hemoglobin (Hb) levels were significantly lower in CAL group (all P<0.05). White blood cell (WBC) count, serum sodium, matrix metalloproteinase 9 (MMP-9), total cholesterol (TC), hematocrit (HCT) and CD3+T lymphocytes percentage had no statistically significant difference between the two groups. In conclusion, our results indicated that the 10 biomarkers including platelet count, neutrophils count, PCT, PDW, MPV, ESR, cTnI, ET-1, Alb and Hb were associated with CAL, and may be involved in the pathogenesis of CAL. The biomarkers of WBC count, serum sodium, MMP-9, TC, HCT, and CD3+T lymphocytes percentage bore no relationship with the development of CAL among Chinese children with KD.

Keywords

Kawasaki disease / coronary artery lesions / Meta-analysis

References

[1] RowleyA.H., ShulmanS.T.. Pathogenesis and management of Kawasaki disease. Expert Rev Anti Infect Ther, 2010, 8(2): 197-203

[2] BurnsJ.C., GlodeM.P.. Kawasaki syndrome. Lancet, 2004, 364(9433): 533-544

[3] NewburgerJ.W., FultonD.R.. Kawasaki disease. Curr Opin Pediatr, 2004, 16(5): 508-514

[4] IemuraM., IshiiM., SugirnuraT., et al.. Long term consequences of regressed coronary aneurysms after Kawasaki disease: vascular wall morphology and function. Heart, 2000, 83(3): 307-311

[5] FukazawaR., OgawaS.. Long-term prognosis of patients with Kawasaki disease: at risk for future atherosclerosis?. J Nippon Med Sch, 2009, 76(3): 124-133

[6] HaradaK.. Intravenous gamma-globulin treatment in Kawasaki disease. Acta Paediatr Jpn, 1991, 33(6): 805-810

[7] WuR., HuY., JiangZ.. . Zhu Futang applied pediatrics, 20027th ed.Beijing, People’s Medical Publishing House, 698-740

[8] KobayashiT., InoueY., TakeuchiK., et al.. Prediction of intravenous immunoglobulin unresponsiveness in patients with Kawasaki disease. Circulation, 2006, 113(22): 2606-2612

[9] ChenJ.J., HuangM., XieL.J., et al.. Study on risky factors of the coronary artery lesion in Kawasaki disease (Chinese). J Clin Pediatr, 2009, 27(5): 442-445

[10] GlassG.V.. Primary, secondary, and Meta-analysis of research. Educ Res, 1976, 5(10): 3-8

[11] AyusawaM., SonobeT., UemuraS., et al.. Kawasaki Disease Research Committee. Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition). Pediatr Int, 2005, 47(2): 232-234

[12] Research Committee on Kawasaki Disease.. . Report of Subcommittee on Standardization of Diagnostic Criteria and Reporting of Coronary Artery Lesions in Kawasaki Disease, 1984, Tokyo, Japan, Ministry of Health and Welfare

[13] LichtensteinM.J., MulrowC.D., ElwoodP.C.. Guidelines for reading case-control studies. J Chronic Dis, 1987, 40(9): 893

[14] EueI., KonigS., PiorJ., et al.. S100A8, S100A9 and the S100A8/A9 heterodimer complex specifically bind to human endothelial cells: identification and characterization of ligands for the myeloid-related proteins S100A9 and S100A8/A9 on human dermal microvascular endothelial cell line-1 cells. Int Immunol, 2002, 14(3): 287-297

[15] TakahashiK., OharasekiT., NaoeS.. . Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease, 2005, Pediatr INT, Official J Jpn Pediatr Society, 305-310

[16] SajiT.. Clinical utility of ulinastatin, urinary protease inhibitor in acute Kawasaki disease. Nippon Rinsho, 2008, 66(2): 343-348

[17] ChuS.G., BeckerR.C., BergerP.B., et al.. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost, 2010, 8(1): 148-156

[18] CoppingerJ.A., CagneyG., ToomeyS., et al.. Characterization of the proteins released from activated platelets leads to localization of novel platelet proteins in human atherosclerotic lesions. Blood, 2004, 103(6): 2096-2104

[19] GawazM., LangerH., MayA.E.. Platelets in inflammation and atherogenesis. J Clin Invest, 2005, 115(12): 3378-3384

[20] O’MalleyT., LanghorneP., EltonR.A., et al.. Platelet size in stroke patients. Stroke, 1995, 26(6): 995-999

[21] BessmanJ.D., WilliamsL.J., GilmerP.R.Jr. Platelet size in health and hematologic disease. Am J Clin Pathol, 1982, 78(2): 150-153

[22] HirshR., LandtY., PortorS., et al.. Cardial troponin I in pediatrics: normal values and potential use in the assessment of cardiac injury. J Padiatr, 1997, 130(6): 872

[23] KimM.. Elevation of cardiac troponin I in the acute stage of Kawasaki disease. Pediatr Cardiol, 1999, 20(3): 184-188

[24] LavalleeM., ThorimE.. Role of ET-1 in the regulation of coronary circulation. Can J Physiol Pharmacol, 2003, 81(6): 570-577

[25] DurongpisitkulK., SoongswangJ., LaohaprasitipornD., et al.. Immunoglobulin failure and retreatment in Kawasaki disease. Pediatr Cardiol, 2003, 24(2): 145-148

[26] BeiserA.S., TakahashiM., BakeA.L., et al.. A predictive instrument for coronary artery aneurysms in Kawasaki disease. US Multicenter Kawasaki Disease Study Group. Am J Cardiol, 1998, 81(9): 1116-1120

[27] LiuJ.P.. Systematic review of not-randomized research (Chinese). J Evid Based Med, 2001, 1(3): 137

[28] JibikiT., TeraiM., KurosakiT., et al.. Efficacy of intravenous immune globulin therapy combined with dexamethasone for the initial treatment of acute Kawasaki disease. Eur J Pediatr, 2004, 163(4–5): 229-233

[29] OkadaY., ShinoharaM., KobayashiT., et al.. Gunma Kawasaki Disease Study Group. Effect of corticosteroids in addition to intravenous gamma globulin therapy on serum cytokine levels in the acute phase of Kawasaki disease in children. J Pediatr, 2003, 143(3): 363-367