Background Kawasaki disease (KD) is an acute febrile systemic vasculitisin childhood that is associated with inflammatory cytokines, in which the vascular inflammation results in damage to the coronary arteries. Vitamin D plays an important role in the regulation of immunity, and several studies demonstrate that its active form 25(OH)VIT exhibits anti-inflammatory activities and modulate the inflammatory response in the systemic vasculitis.
Objectives 1. To assess serum levels of 25(OH)VITD in children with KD, and 2. to evaluate the possible relationship between 25(OH)VITD deficiency and coronary artery damage in these patients.
Methods We evaluated 25(OH)VITD serum levels in 60patients with KD (18 females, 42 males, mean age at KD diagnosis 23.8±15.4 years). These patients were compared with a sex- and age-matched control group. In all patients 25(OH)VITD serum levels were measured in the acute phase of the illness before IVIG treatment. All patients received timely the current treatment for KD, IVIG 2 g/kg and aspirin (30-50 mg/kg). Among the 60 pts 3 developed coronary artery aneurysms (diameter >5 mm <8 mm) and 2 coronary ectasia.
Results KD patients showed significantly reduced 25(OH)VITD levels (8.90±2.24 mg/dl) in comparison to controls (21.70±4.35 mg/dl; p<0.0001). We did not detectany significant difference among KD patients with less and more than 1 years of age (9.05±2.31 mg/dl vs 9.20±2.61 mg/dl). On the contrary, we observed significant differences in KD patients both with and without coronary aneurysms (7.48±2.33 mg/dl vs 9.90±2.81 mg/dl; p<0.05).
Conclusions 25(OH)VITD might have a role in the development of coronary damage. Yet, low 25(OH)VITD levels might contribute to the chronic course and severity of coronary aneurysms in the KD. Future larger studies are needed to explore the relationship between serum 25(OH)VITDlevels and KD cardiac damage.
Kudo K, Hasegawa S, Suzuki Y, Hirano R, Wakiguchi H, Kittaka S, Ichiyama T.1α,25-Dihydroxyvitamin D(3) inhibits vascular cellular adhesion molecule-1 expression and interleukin-8 production in human coronary arterial endothelial cellsJ Steroid BiochemMolBiol 2012;132:290-4.
Suzuki Y, Ichiyama T, Ohsaki A, Hasegawa S, Shiraishi M, Furukawa S.Anti-inflammatory effect of 1alpha,25-dihydroxyvitamin D(3) in human coronary arterial endothelial cells: Implication for the treatment of Kawasaki disease.J Steroid BiochemMol Biol. 2009;113:134-8.
Disclosure of Interest None declared