title: Oxidative stress and defective platelet apoptosis in naïve patients with Kawasaki disease.
abstract: Kawasaki disease (KD) is a rare and often undiagnosed disease, at least in the western countries. It is characterized by an inflammatory acute febrile vasculitis of medium sized arteries with a propensity to damage the coronary arteries. It normally occurs in the early childhood and the diagnosis is based on clinical symptoms. During the progression of the disease thrombocytosis is usually detected. This can exert a pathogenetic role in the cardiovascular complications occurring in KD. In the present work peripheral blood plasma and platelets from twelve naïve patients with KD were analyzed in order to detect possible pathogenetic determinants or progression markers. Morphological, biochemical and flow cytometrical methods have been used. With respect to age-matched healthy donors, we found an increase of platelet activation markers, i.e. degranulation, phosphatidylserine (PS) externalization and leukocyte-red cell-platelet aggregates. Some significant alterations that could represent suitable diagnostic determinants have also been detected in patient plasma: (i) decreased antioxidant power, (ii) decreased levels of asymmetric dymethylarginine (ADMA), a naturally occurring chemical interfering with the production of nitric oxide, and (iii) increased levels of soluble P-Selectin and soluble annexin V. Since PS externalizing platelets are known to exert a pro-coagulant activity, our data suggest the hypothesis that increased risk of vascular complications in KD could depend on platelet stimulation and defective apoptosis probably related to nitrosative stress.
authors.affiliation: Department of Drug Research and Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Straface
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Gambardella
authors.forename: Alessio
authors.initials: A
authors.lastname: Metere
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marchesi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Palumbo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Cortis
authors.forename: Alberto
authors.initials: A
authors.lastname: Villani
authors.forename: Donatella
authors.initials: D
authors.lastname: Pietraforte
authors.forename: Marina
authors.initials: M
authors.lastname: Viora
authors.forename: Walter
authors.initials: W
authors.lastname: Malorni
authors.forename: Domenico
authors.initials: D
authors.lastname: Del Principe
mesh_terms: D017209:Apoptosis; D015415:Biomarkers; D001792:Blood Platelets / Q000473:pathology*; D006801:Humans; D007223:Infant; D009080:Mucocutaneous Lymph Node Syndrome / Q000473:pathology*; D018384:Oxidative Stress
chemical_list: D015415:Biomarkers