Association of toll-like receptor 2-positive monocytes with coronary artery lesions and treatment nonresponse in Kawasaki disease

Soo Jung Kang, Nam Su Kim

Research output: Contribution to journalArticle

Abstract

Purpose: Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL- 10). Methods: The frequency of circulating TLR2+/CD14+ monocytes (FTLR2%) in patients with KD was measured by flow cytometry. Serum levels of IL-10 (sIL-10) were determined in 31 patients with KD before the initial treatment with intravenous immunoglobulin (IVIG) and in 21 febrile controls by using enzyme-linked immunosorbent assay. Patients were classified as having coronary artery lesions (CALs) based on the maximal internal diameters of the proximal right coronary artery and proximal left anterior descending coronary artery one month after the initial diagnosis. Results: We found that FTLR2% greater than 92.62% predicted CALs with 80% sensitivity and 68.4% specificity, whereas FTLR2% more than 94.61% predicted IVIG resistance with 66.7% sensitivity and 71.4% specificity. Moreover, sIL-10 more than 15.52 pg/mL predicted CALs and IVIG resistance with 40% and 66.7% sensitivity, respectively, and 73.7% and 76.2% specificity, respectively. Conclusion: We showed that measuring FTLR2% before the initial treatment could be useful in predicting CAL development with better sensitivity than sIL-10 and with results comparable to sIL-10 results for the prediction of IVIG resistance in patients with KD. However, further studies are necessary to validate FTLR2% as a marker of prognosis and severity of KD.

Original languageEnglish
Pages (from-to)208-215
Number of pages8
JournalKorean Journal of Pediatrics
Volume60
Issue number7
DOIs
StatePublished - 2017 Jul

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Toll-Like Receptor 2
Mucocutaneous Lymph Node Syndrome
Monocytes
Coronary Vessels
Interleukin-10
Intravenous Immunoglobulins
Serum
Therapeutics
Sensitivity and Specificity
Flow Cytometry
Fever
Enzyme-Linked Immunosorbent Assay
Cytokines

Keywords

  • Coronary arteries
  • Immunoglobulins
  • Interleukins
  • Kawasaki disease
  • Toll-like receptors

Cite this

@article{475740467df145fc978d62a409d75ebb,
title = "Association of toll-like receptor 2-positive monocytes with coronary artery lesions and treatment nonresponse in Kawasaki disease",
abstract = "Purpose: Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL- 10). Methods: The frequency of circulating TLR2+/CD14+ monocytes (FTLR2{\%}) in patients with KD was measured by flow cytometry. Serum levels of IL-10 (sIL-10) were determined in 31 patients with KD before the initial treatment with intravenous immunoglobulin (IVIG) and in 21 febrile controls by using enzyme-linked immunosorbent assay. Patients were classified as having coronary artery lesions (CALs) based on the maximal internal diameters of the proximal right coronary artery and proximal left anterior descending coronary artery one month after the initial diagnosis. Results: We found that FTLR2{\%} greater than 92.62{\%} predicted CALs with 80{\%} sensitivity and 68.4{\%} specificity, whereas FTLR2{\%} more than 94.61{\%} predicted IVIG resistance with 66.7{\%} sensitivity and 71.4{\%} specificity. Moreover, sIL-10 more than 15.52 pg/mL predicted CALs and IVIG resistance with 40{\%} and 66.7{\%} sensitivity, respectively, and 73.7{\%} and 76.2{\%} specificity, respectively. Conclusion: We showed that measuring FTLR2{\%} before the initial treatment could be useful in predicting CAL development with better sensitivity than sIL-10 and with results comparable to sIL-10 results for the prediction of IVIG resistance in patients with KD. However, further studies are necessary to validate FTLR2{\%} as a marker of prognosis and severity of KD.",
keywords = "Coronary arteries, Immunoglobulins, Interleukins, Kawasaki disease, Toll-like receptors",
author = "Kang, {Soo Jung} and Kim, {Nam Su}",
year = "2017",
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doi = "10.3345/kjp.2017.60.7.208",
language = "English",
volume = "60",
pages = "208--215",
journal = "Korean Journal of Pediatrics",
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T1 - Association of toll-like receptor 2-positive monocytes with coronary artery lesions and treatment nonresponse in Kawasaki disease

AU - Kang, Soo Jung

AU - Kim, Nam Su

PY - 2017/7

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N2 - Purpose: Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL- 10). Methods: The frequency of circulating TLR2+/CD14+ monocytes (FTLR2%) in patients with KD was measured by flow cytometry. Serum levels of IL-10 (sIL-10) were determined in 31 patients with KD before the initial treatment with intravenous immunoglobulin (IVIG) and in 21 febrile controls by using enzyme-linked immunosorbent assay. Patients were classified as having coronary artery lesions (CALs) based on the maximal internal diameters of the proximal right coronary artery and proximal left anterior descending coronary artery one month after the initial diagnosis. Results: We found that FTLR2% greater than 92.62% predicted CALs with 80% sensitivity and 68.4% specificity, whereas FTLR2% more than 94.61% predicted IVIG resistance with 66.7% sensitivity and 71.4% specificity. Moreover, sIL-10 more than 15.52 pg/mL predicted CALs and IVIG resistance with 40% and 66.7% sensitivity, respectively, and 73.7% and 76.2% specificity, respectively. Conclusion: We showed that measuring FTLR2% before the initial treatment could be useful in predicting CAL development with better sensitivity than sIL-10 and with results comparable to sIL-10 results for the prediction of IVIG resistance in patients with KD. However, further studies are necessary to validate FTLR2% as a marker of prognosis and severity of KD.

AB - Purpose: Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL- 10). Methods: The frequency of circulating TLR2+/CD14+ monocytes (FTLR2%) in patients with KD was measured by flow cytometry. Serum levels of IL-10 (sIL-10) were determined in 31 patients with KD before the initial treatment with intravenous immunoglobulin (IVIG) and in 21 febrile controls by using enzyme-linked immunosorbent assay. Patients were classified as having coronary artery lesions (CALs) based on the maximal internal diameters of the proximal right coronary artery and proximal left anterior descending coronary artery one month after the initial diagnosis. Results: We found that FTLR2% greater than 92.62% predicted CALs with 80% sensitivity and 68.4% specificity, whereas FTLR2% more than 94.61% predicted IVIG resistance with 66.7% sensitivity and 71.4% specificity. Moreover, sIL-10 more than 15.52 pg/mL predicted CALs and IVIG resistance with 40% and 66.7% sensitivity, respectively, and 73.7% and 76.2% specificity, respectively. Conclusion: We showed that measuring FTLR2% before the initial treatment could be useful in predicting CAL development with better sensitivity than sIL-10 and with results comparable to sIL-10 results for the prediction of IVIG resistance in patients with KD. However, further studies are necessary to validate FTLR2% as a marker of prognosis and severity of KD.

KW - Coronary arteries

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KW - Interleukins

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