title: Ethnic Kawasaki Disease Risk Associated with Blood Mercury and Cadmium in U.S. Children.
abstract: Kawasaki disease (KD) primarily affects children <5 years of age (75%-80%) and is currently the leading cause of acquired heart disease in developed nations. Even when residing in the West, East Asian children are 10 to 20 times more likely to develop KD. We hypothesized cultural variations influencing pediatric mercury (Hg) exposure from seafood consumption may mediate ethnic KD risk among children in the United States. Hospitalization rates of KD in US children aged 0-4 years (n = 10,880) and blood Hg levels in US children aged 1-5 years (n = 713) were determined using separate US federal datasets. Our cohort primarily presented with blood Hg levels <0.1 micrograms (µg) per kg bodyweight (96.5%) that are considered normal and subtoxic. Increased ethnic KD risk was significantly associated with both increasing levels and detection rates of blood Hg or cadmium (Cd) in a linear dose-responsive manner between ethnic African, Asian, Caucasian, and Hispanic children in the US (p ≤ 0.05). Increasing low-dose exposure to Hg or Cd may induce KD or contribute to its later development in susceptible children. However, our preliminary results require further replication in other ethnic populations, in addition to more in-depth examination of metal exposure and toxicokinetics.
authors.affiliation: Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. deniz.aydin.yeter@gmail.com.
authors.forename: Deniz
authors.initials: D
authors.lastname: Yeter
authors.affiliation: Division of Cardiology, Department of Pediatrics, Seattle Children's Research Institute, University of Washington, Seattle, WA 98101, USA. michael.portman@seattlechildrens.org.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Portman
authors.affiliation: Department of Molecular Pharmacology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, USA. michael.aschner@einstein.yu.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Aschner
authors.affiliation: Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina 88040, Brazil. marcelo.farina@ufsc.br.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Farina
authors.affiliation: Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. wenching.chan@gmail.com.|Genomics and Proteomics Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. wenching.chan@gmail.com.
authors.forename: Wen-Ching
authors.initials: WC
authors.lastname: Chan
authors.affiliation: Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. kshsieh@hotmail.com.|Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. kshsieh@hotmail.com.|College of Medicine, Chang Gung University, Gueishan, Taoyuan 33302, Taiwan. kshsieh@hotmail.com.
authors.forename: Kai-Sheng
authors.initials: KS
authors.lastname: Hsieh
authors.affiliation: Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. erickuo48@yahoo.com.tw.|Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Niaosong, Kaohsiung 83301, Taiwan. erickuo48@yahoo.com.tw.|College of Medicine, Chang Gung University, Gueishan, Taoyuan 33302, Taiwan. erickuo48@yahoo.com.tw.
authors.forename: Ho-Chang
authors.initials: HC
authors.lastname: Kuo
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002104:Cadmium / Q000097:blood* / Q000633:toxicity*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008628:Mercury / Q000097:blood* / Q000633:toxicity*; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000208:ethnology / Q000209:etiology*; D012307:Risk Factors; D017747:Seafood / Q000633:toxicity*; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D002104:Cadmium; D008628:Mercury
keywords: Kawasaki disease; allergy; autoimmunity; infantile acrodynia; mercury; methylmercury; pediatrics; pollution; seafood; toxicology