Macrophage migration inhibitory factor -173 polymorphism and risk of coronary alterations in children with Kawasaki disease.
OBJECTIVE
To investigate the possible relationship between MIF -173 polymorphism and susceptibility to, and severity of, Kawasaki disease (KD) in a cohort of Italian patients.


METHODS
Sixty-nine patients (43 F, 26 M, median age 29 months, range 3-135 months) with KD and 60 sex-matched healthy caucasian children were genotyped for MIF-173. Typing of the MIF gene -173 G/C was performed by PCR and restriction fragment length polymorphism.


RESULTS
Eight out of 69 (12%) KD children were non-responders: 7 required an additional IVIG infusion, while 1 received 2 IVIG infusions and then steroid administration. 9/69 (13%) KD children developed coronary artery abnormalities (CAA) during the second to fourth week of disease, and 4 of them required an additional IVIG infusion. MIF genotyping did not show significant differences between patients and controls. KD patients carrying a MIF -173*C allele developed CAA more frequently than those without MIF- (7/9 77.8% vs. 16/60 26.7%, OR 9.6, 95% CI 1.80-21.2, p<0.005). Non-responders to a single IVIG infusion carried the MIF -173*C allele more frequently than responders (6/8 = 75% vs. 17/61 = 28%, OR 5.1, 95% CI 1.42-22.31 p<0.014). In multiple regression analysis, KD patients carrying a MIF -173*C allele were found to have an increased risk of coronary involvement (OR 7.7, 95% CI 1.36-16.1, p=0.021).


CONCLUSIONS
We showed that children carrying the MIF polymorphism -173*C had a higher percentage of CAA. A potential relationship between a MIF polymorphism and risk of CAA in KD might be considered.
Department of Paediatrics, Rheumatology Unit, A. Meyer Children's Hospital, Florence, Italy. gabriele.simonini@unifi.it
G
G
Simonini
E
E
Corinaldesi
C
C
Massai
F
F
Falcini
F
F
Fanti
M
M
De Martino
R
R
Cimaz
D000483:Alleles; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007558:Italy; D008263:Macrophage Migration-Inhibitory Factors / Q000235:genetics*; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000235:genetics* / Q000628:therapy; D009154:Mutation / Q000235:genetics; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D012307:Risk Factors; D012720:Severity of Illness Index
D016756:Immunoglobulins, Intravenous; D008263:Macrophage Migration-Inhibitory Factors