IVIG reduced vascular oxidative stress in patients with Kawasaki disease.
BACKGROUND
Oxidative stress (OS) contributes to the acute phase of Kawasaki disease (KD) in a manner that is as yet unknown. In the present study OS in the acute phase of KD was investigated by measuring urinary 8-iso-prostaglandin F2alpha (8-iso-PG) and evaluating its correlation to the efficacy of intravenous immunoglobulin (IVIG) administration.


RESULTS
The 62 patients with acute phase of KD were enrolled, as well as 20 healthy children (HC) and 20 with acute febrile illness (FI). Urinary samples were obtained before and after administration of IVIG. The HC and FI groups also had inflammatory markers evaluated at the same time. The 8-iso-PG was significantly elevated in the 62 KD patients (719 +/-335 pg/mg Cr) without IVIG administration compared with those with FI (583 +/-213 pg/mg Cr) as well as HC (443 +/-288 pg/mg Cr) (P<0.01). 40 patients were given 3 different regimens of IVIG: 16 received 2 g/kg for 1 day; 17 received 1 g/kg for 1 day; 7 received 400 mg . kg(-1) . day(-1) for 5 days. All regimens of IVIG reduced the 8-iso-PG level at 7 days after initiation.


CONCLUSIONS
OS provokes vasculitis in KD, the activation of which was reduced by IVIG. The urinary level of 8-iso-PG is a useful marker of the effectiveness of IVIG in the acute phase of KD.
Pediatrics, Toho University Omori Medical Center, Omorinishi, Ota-ku, Tokyo, Japan. tekeshin0621@msn.com
Shinichi
S
Takatsuki
Yuka
Y
Ito
Daiji
D
Takeuchi
Hiroshi
H
Hoshida
Tomotaka
T
Nakayama
Hiroyuki
H
Matsuura
Tsutomu
T
Saji
D000208:Acute Disease; D000210:Acute-Phase Reaction; D015415:Biomarkers / Q000652:urine; D002648:Child; D002675:Child, Preschool; D015237:Dinoprost / Q000031:analogs & derivatives / Q000652:urine; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology* / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000494:pharmacology* / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D018384:Oxidative Stress / Q000187:drug effects* / Q000502:physiology; D016896:Treatment Outcome
D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost