Association of Genetic Polymorphisms in Kawasaki Disease with the Response to Intravenous Immunoglobulin Therapy

Pediatr Cardiol. 2023 Jan;44(1):1-12. doi: 10.1007/s00246-022-02973-2. Epub 2022 Jul 30.

Abstract

Kawasaki disease (KD) is an acute febrile and systemic vasculitis disease mainly affecting children < 5 years old. Although the first case of KD was reported in 1967 and despite extensive research on KD since then, the cause of the disease remains largely unknown. The most common complications of KD are coronary artery lesions (CAL), which significantly increase the risk of coronary heart disease. The standard treatment for KD is high-dose intravenous immunoglobulin (IVIG) plus aspirin within 10 days from symptoms' appearance, which has been shown to decrease the incidence of CAL to 5-7%. Despite the benefits of IVIG, about 25% of the patients treated with IVIG develop resistance or are unresponsive to the therapy, which represents an important risk factor for CAL development. The cause of IVIG unresponsiveness has not been fully elucidated. However, the role of gene polymorphisms in IVIG response has been suggested. Herein, we comprehensively review genetic polymorphisms in KD that have been associated with IVIG resistance/unresponsiveness and further discuss available models to predict IVIG unresponsiveness.Kindly check and confirm inserted city in affiliation [1] is correctly identified.confirm.

Keywords: Coronary artery lesion; Intravenous immunoglobulin; Kawasaki disease; Resistance.

Publication types

  • Review

MeSH terms

  • Aspirin
  • Child, Preschool
  • Coronary Artery Disease* / complications
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Infant
  • Mucocutaneous Lymph Node Syndrome* / complications
  • Mucocutaneous Lymph Node Syndrome* / drug therapy
  • Mucocutaneous Lymph Node Syndrome* / genetics
  • Polymorphism, Genetic
  • Risk Factors

Substances

  • Aspirin
  • Immunoglobulins, Intravenous