Changes in 11β-Hydroxysteroid Dehydrogenase and Glucocorticoid Receptor Expression in Kawasaki Disease

Abstract

Background and ObjectivesThis study aims to investigate the significance of changes in the expression 11β-hydroxysteroid dehydrogenase (11β-HSD) and glucocorticoid receptor (GR) for the development of Kawasaki disease (KD).Subjects and MethodsReal-time polymerase chain reaction was performed to determine the mRNA expression levels of GR and 11β-HSD in peripheral blood monocytes, both in the acute phase of the disease and after treatment. Western blotting was performed to determine the protein expression levels of GR and 11β-HSD.ResultsThe expression levels of GRβ, GRβ, and 11β-HSD1 mRNA in the acute phase were significantly higher than levels at baseline (p<0.01) and after treatment (p<0.05). The 11β-HSD2 mRNA levels were lower in the acute phase than in the normal group (p<0.01), and they were significantly higher after treatment than before (p<0.01). Western blot results were consistent with the real-time PCR results. The coronary artery lesion group exhibited significantly different 11β-HSD2 expression levels from that of the group with normal coronary arteries (p<0.01).ConclusionGR and 11β-HSD expression changes in the acute phase of KD are important factors for regulating inflammatory responses in KD.

State-of-the-art acute phase management of Kawasaki disease after 2017 scientific statement from the American Heart Association

“…6,8 In Taiwan, the cumulative incidence of KD among children aged less than 5 years is 2.78 per thousand children, and the time trend with the birth year has increased from 2.28 per thousand children in 2000 to 3.67 per thousand children in 2009. 9 Each year, we estimate that approximately 700 patients are newly diagnosed with KD in Taiwan. A program from a cross-section point of view in Taiwan can also provide an estimate of patients with KD-associated complications such as coronary artery sequelae.…”

“…The case fatality rate is <0.1% in both Japan and Taiwan. 6,9 The peak seasons of KD are late spring and summer in Taiwan. 11…”