title: Serum Tenascin-C as a Novel Predictor for Risk of Coronary Artery Lesion and Resistance to Intravenous Immunoglobulin in Kawasaki Disease　- A Multicenter Retrospective Study.
abstract: Tenascin-C (TN-C) is an extracellular matrix glycoprotein that is heavily upregulated at sites of inflammation. We conducted a retrospective study to assess the utility of TN-C as a novel biomarker to predict the risk of developing coronary artery lesions (CAL) and resistance to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD).
  
  
  
  We collected blood samples of 111 KD patients (IVIG-responder: 89, IVIG-resistant: 22; CAL: 8) and 23 healthy controls, and measured the serum levels of TN-C. TN-C levels on admission were significantly higher in patients than in healthy controls and in patients during convalescence after IVIG administration (69.6 vs. 20.4 vs. 39.7 ng/ml, respectively; P<0.001), and correlated positively with C-reactive protein (P<0.001), neutrophil (percentage; P=0.005), and ALT (P<0.001), and negatively with platelet count (P=0.023) and sodium level (P=0.025). On admission, TN-C levels in patients who later developed CAL were significantly higher than in those without CAL (P=0.010), and significantly higher in IVIG-resistant subjects than in IVIG-responders (P=0.003). The accuracy of TN-C testing for the prediction of IVIG resistance was comparable to that of the Kobayashi score.
  
  
  
  Serum TN-C could be a biomarker for predicting the risk of developing CAL and IVIG resistance during the acute phase of KD. (Circ J 2016; 80: 2376-2381).
authors.affiliation: Department of Pediatrics, National Center for Global Health and Medicine.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Okuma
authors.forename: Kenji
authors.initials: K
authors.lastname: Suda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nakaoka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Katsube
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Mitani
authors.forename: Yukako
authors.initials: Y
authors.lastname: Yoshikane
authors.forename: Fukiko
authors.initials: F
authors.lastname: Ichida
authors.forename: Takeji
authors.initials: T
authors.lastname: Matsushita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shichino
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.forename: Jun
authors.initials: J
authors.lastname: Abe
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hiroe
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imanaka-Yoshida
mesh_terms: D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003331:Coronary Vessels / Q000378:metabolism*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors; D019063:Tenascin / Q000097:blood*
chemical_list: D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D019063:Tenascin