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Association amongmeprin A,  IL-1β and IVIG-ineffective Kawasaki disease

  

  1. 1. Ningbo University School of Medicine,  Ningbo 315000,  China; 2. Department of
    Pediatric Rheumatology,  Ningbo Women & Children's  Hospital, Ningbo 315000,  China;
    3. Department of Pediatric Rheumatology,  Ningbo First Hospital,  Ningbo 315000,  China
  • Online:2020-06-20 Published:2020-05-18
  • Contact: Corresponding author: Di Yazhen, Email: dyz028sci@163.com

Abstract: Objective  To explore the predictive value of meprin A and interleukin1β for gamma globulinin ineffective Kawasaki disease(KD).Methods  A total of 410 KD patients were selected as test group, and 210 patients with upper respiratory tract infection were selected as control group. KD patients were further divided into IVIGeffective group and IVIGineffective group according to the initial treatment outcome of IVIG. All KD patients were tested for laboratory indicators, such as meprin A and IL1β in acute and recovery phase.Results  ①The levels of IL1β and meprin A in KD patients in the acute phase were higher than those in the control group and in KD patients in the remissionphase (P<0.01). ②There was strong positive correlation between meprin A and IL1β levels in KD children(r=0.635,P<0.01).③ The levels of  meprin A and IL1β in IVIGineffective group were higher than those in IVIGeffective  group. There were statistically significant differences in the feverprocess,the first application of intravenous gamma globulin,blood WBC,CRP,ESR and NTproBNP between the two groups (P<0.01). ④ When the blood meprin A was higher than or equal to 12.95 ng/ml,its sensitivity and specificity for predicting IVIGineffective KD was 81.8% and 89.6%,respectively;When IL1β was higher than or equal to 4.05 pg/ml,its sensitivity and specificity was 61.8% and  87.3%,respectively;When both of the above conditions were met,the specificity was  94.9%.Conclusion  Meprin A and IL1β may participate in the pathogenesis of KD, so they can be seen as an indicator to evaluate the disease activity of KD and better predict IVIGineffective KD.

Key words: mucocutanious lymph node syndrome; , gammaglobulins, cytokines