| Co-Investigator(Kenkyū-buntansha) |
NISHIYORI Atsushi Department of Pediatrics Kurume University School of Medicine, 医学部, 講師 (30218226)
ISHII Masahiro Department of Pediatrics Kurume University School of Medicine, 医学部, 講師 (90222950)
AKAGI Teiji Department of Pediatrics Kurume University School of Medicine, 医学部, 講師 (80231801)
KAMIZONO Shintaro Department of Pediatrics Kurume University School of Medicine, 医学部, 助手 (30261077)
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| Research Abstract |
The peripheral blood mononuclear cells of Kawasaki disease (KD) patients with coronary artery lesions produced higher levels of tumor necrosis factor (TNF)-alpha in response to bacterial products. None of the polymorphisms in the 5 flanking region of the TNF-alpha gene were related to KD.These results suggest that a genetic disposition towards overproduction of TNF-alpha in response to bacterial products may be involved in the pathogenesis of KD (Kamizono S, Kato H, et al. Pediatr Int. 1999). We investigated the coronary endothelial function using intracoronary infusions of acetylcholine and isosorbide dinitrate and evaluated vascular wall morphology using intravasucular ultrasound (IVUS) imaging long-term after KD.Long-term coronary artery lesions, even after aneurysm regression, may have impaired endothelial function and abnormal vascular wall morphology (Yamakawa R, Kato H, et al. JACC, 1998, Iemura M, Kato H, et al. Heart 2000). The steroid pulse therapy migt be useful in patients with intravenous immune globulin (IVIG)-resistant Kawasaki disease who experience prolonged fever. However, transient dilatation of the coronary artery was observed during steroid pulse therapy (Hashino K, Kato H, et al. Pediatr Int, in press). We investigated the relationship between the plasma levels of soluble forms of selectin family (P-, E-, and L- selectin) and the incidence of CAL in KD patients. Alterations in plasma selectin levels are important clinical molecular markers KD patients. E-selectin molecules may have potential as a predictor of incidence of CAL in patients with KD (Furui J Kurume Med J, in press). Vascular endothelial growth factor (VEGF) was involved in the pathogenesis of KD, especially in the developing of CAL.The VEGF may have possibility to become useful predictor of CAL in patients with IVIG resistant KD (Furui J, Kato H, et al. JACC 2001, abstract).
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