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Ko TM, Kuo HC, Chang JS, Chen SP, Liu YM, Chen HW, Tsai FJ, Lee YC, Chen CH, Wu JY, Chen YT. CXCL10/IP-10 is a biomarker and mediator for Kawasaki disease. Circ Res 2015; 116:876-83. [PMID: 25605650 DOI: 10.1161/circresaha.116.305834] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
RATIONALE Kawasaki disease (KD), an acute febrile vasculitis, is the most common cause of acquired heart disease in childhood; however, diagnosing KD can be difficult. OBJECTIVE To identify unique proteomic biomarkers that can be used to facilitate earlier diagnosis of KD. METHODS AND RESULTS We enrolled 214 children with fever and clinical features suggestive of KD. Of those, only 100 were diagnosed with KD. Their plasma samples were globally analyzed for cytokines, chemokines, and cell adhesion molecules using an unbiased, large-scale, quantitative protein array. This study was conducted in 3 stages: discovery, replication, and blinded validation. During the discovery phase (n [KD]=37; n [control]=20), the expression of interleukin-17F, sCD40L, E-selectin, CCL23 (myeloid progenitor inhibitory factor 1), and CXCL10 (IFN-γ-inducible protein 10 [IP-10]) were upregulated during the acute phase in patients with KD when compared with that in the controls. A notable increase was observed in the IP-10 levels (KD, 3037 ± 226.7 pg/mL; control, 672 ± 130.4 pg/mL; P=4.1 × 10(-11)). Receiver-operating characteristic analysis of the combined discovery and replication data (n [KD]=77; n [control]=77) showed that the IP-10 level had high area under the curve values (0.94 [95% confidence interval, 0.9055-0.9778]; sensitivity, 100%; and specificity, 77%). With 1318 pg/mL as the optimal cutoff, the blinded validation study confirmed that the IP-10 levels were a good predictor of KD. With intravenous immunoglobulin treatment, the IP-10 levels returned to normal. The downstream receptor of IP-10, CXCR3, was activated in the T cells of patients with acute KD. CONCLUSIONS IP-10 may be used as a biomarker to facilitate KD diagnosis, and it may provide clues about the pathogenesis of KD.
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Affiliation(s)
- Tai-Ming Ko
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Ho-Chang Kuo
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Jeng-Sheng Chang
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Shih-Ping Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Yi-Min Liu
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Hui-Wen Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Fuu-Jen Tsai
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Yi-Ching Lee
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Chien-Hsiun Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.)
| | - Jer-Yuarn Wu
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.).
| | - Yuan-Tsong Chen
- From the Institute of Biomedical Sciences (T.-M.K., S.-P.C., Y.-M.L., H.-W.C., C.-H.C., J.-Y.W., Y.-T.C.) and Institute of Cellular and Organismic Biology (Y.-C.L.), Academia Sinica, Taipei, Taiwan; Department of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-C.K.); Chang Gung University College of Medicine, Taoyuan, Taiwan (H.-C.K.); Department of Pediatric Cardiology, Children's Hospital of China Medical University, Taichung, Taiwan (J.-S.C.); School of Medicine (J.-S.C.), School of Chinese Medicine (F.-J.T.), and Department of Medical Genetics (F.-J.T., C.-H.C., J.-Y.W.), China Medical University Hospital, Taichung, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan (F.-J.T.); and Department of Pediatrics, Duke University Medical Center, Durham, NC (Y.-T.C.).
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