scholarly journals Serum miR-200c and miR-371-5p as the Useful Diagnostic Biomarkers and Therapeutic Targets in Kawasaki Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Wei Zhang ◽  
Yan Wang ◽  
Yiwen Zeng ◽  
Liyi Hu ◽  
Guotao Zou
Keyword(s):  
Kawasaki Disease ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Therapeutic Targets ◽  
Ivig Therapy ◽  
High Dose ◽  
Healthy Controls ◽  
Diagnostic Biomarkers ◽  
Qrt Pcr ◽  
Serum Micrornas

Kawasaki disease (KD) has complexly clinical features and laboratory parameters and there is no definitive biomarker for this disease and the therapy of KD also is complex and uncertain. In this study, 102 KD patients and 80 healthy controls were enrolled in this study and the serum microRNAs were detected by qRT-PCR. The results showed that, compared with KD patients with a good response to high-dose intravenous immunoglobulin (IVIG) therapy, serum miR-200c and miR-371-5p were significantly higher in KD patients with no response to IVIG therapy; compared with KD patients not needing plasma exchange, these two microRNAs were also significantly higher in KD patients needing plasma exchange. In addition, combination of serum miR-200c and miR-371-5p reflected obvious separation between KD patients and healthy controls or between KD patients with no response to IVIG therapy and KD patients with good response to IVIG therapy or KD patients needing plasma exchange and KD patients not needing plasma exchange. Finally, both serum miR-200c and miR-371-5p were also significantly lower in KD under different kinds of therapy. Therefore, serum miR-200c and miR-371-5p have ability as the useful diagnostic biomarkers and therapeutic targets in Kawasaki disease.

Efficacy and Limitation of Infliximab Treatment for Children with Kawasaki Disease Intractable to Intravenous Immunoglobulin Therapy: Report of an Open-label Case Series

2012 ◽  
Vol 39 (4) ◽  
pp. 864-867 ◽  
Author(s):  
MASAAKI MORI ◽  
TOMOYUKI IMAGAWA ◽  
RYOKI HARA ◽  
MASAKO KIKUCHI ◽  
TAKUMA HARA ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Ivig Therapy ◽  
High Dose ◽  
Infliximab Treatment ◽  
Coronary Artery Lesions ◽  
Open Label ◽  
Intravenous Immunoglobulin Therapy ◽  
Cell Counts

Objective.Kawasaki disease (KD) is an acute febrile disease in infants and young children. Five percent to 8% of cases will be complicated with coronary dilatation or aneurysm, although introduction of high-dose intravenous immunoglobulin (IVIG) therapy has provided remarkable results for reducing the frequency of cardiac involvement. We describe the results of an open-label trial of infliximab, an anti-tumor necrosis factor-α monoclonal antibody, for suppressing the progression of coronary artery lesions in cases of KD refractory to extensive IVIG therapy. Plasma exchange (PE) was available as a rescue therapy for patients refractory to infliximab.Methods.Twenty eligible patients fulfilled the diagnostic criteria for KD, and were primarily treated with IVIG up to 4 g/kg. “Refractory to IVIG” was defined as persisting or reemerging fever > 38°C and positive fractional changes of C-reactive protein, white blood cell counts, or neutrophil counts 48 hours after IVIG infusion. These cases were treated with infliximab, 5 mg/kg, which should begin within 10 days of disease onset. PE for patients refractory to infliximab was performed with 5% albumin.Results.There was rapid improvement of inflammatory symptoms as well as normalization of the inflammatory markers. Sequential examination by echocardiography up to disease Day 30 revealed that the inflamed and mildly dilated coronary artery at the beginning of the study regressed to normal size in the convalescent phase. Two out of 20 patients showed incomplete improvement of inflammatory symptoms after infliximab treatment, and were provided with PE therapy, with no complications.Conclusion.Eighteen of 20 patients were effectively treated with infliximab, and 2 cases were effectively treated with PE to prevent progression to coronary artery lesions. No adverse event such as anaphylactoid reaction, heart failure, severe infectious diseases, or tuberculosis was observed in this trial.

Cerebral infarction after high-dose intravenous immunoglobulin therapy for Kawasaki disease

2006 ◽  
Vol 148 (3) ◽  
pp. 399-400 ◽  
Author(s):  
Yasunori Wada ◽  
Atsushi Kamei ◽  
Yukiharu Fujii ◽  
Ken Ishikawa ◽  
Shoichi Chida
Keyword(s):  
Kawasaki Disease ◽  
Cerebral Infarction ◽  
Intravenous Immunoglobulin ◽  
Immunoglobulin Therapy ◽  
High Dose ◽  
Intravenous Immunoglobulin Therapy

scholarly journals Functional benefits of corticosteroid and IVIG combination therapy in a coronary artery endothelial cell model of Kawasaki disease

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Takashi Inoue ◽  
Shokei Murakami ◽  
Kenji Matsumoto ◽  
Akio Matsuda
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Combination Therapy ◽  
Molecular Mechanisms ◽  
Ivig Therapy ◽  
Unknown Etiology ◽  
High Dose ◽  
Ivig Resistance ◽  
Tnf Α ◽  
Clinical Benefits

Abstract Background Kawasaki disease (KD) is the most common pediatric systemic vasculitides of unknown etiology. Recent clinical studies led to reappraisal of the usefulness of initial combination therapy of intravenous immunoglobulin (IVIG) plus a corticosteroid for patients with severe KD. However, the molecular mechanisms underlying the clinical benefits of that combination therapy remain unclear. Here, we used cultured human coronary artery endothelial cells (HCAECs), as a mimic of KD, to study the possible mechanisms responsible for the clinical benefits of adding a corticosteroid to standard IVIG therapy for patients with severe KD. Methods HCAECs were stimulated with TNF-α, IL-1α or IL-1β in the presence and absence of high-dose IgG and/or dexamethasone (DEX). The mRNA and protein concentrations for high-mobility group box-1 (HMGB1), IL-1α, IL-6 and granulocyte-colony stimulating factor (G-CSF) in the culture supernatants were measured by quantitative PCR (qPCR) and ELISA, respectively. Apoptosis was evaluated by the caspase 3/7 activities. Results DEX, but not IgG, significantly inhibited apoptosis caused by inflammatory stimuli, resulting in effective reduction of HMGB1 and IL-1α protein release by HCAECs. As previously reported, DEX or IgG alone significantly suppressed TNF-α-induced production of IL-6 and G-CSF and mRNA expression, but induction of those cytokines by IL-1 s (IL-1α and IL-1β) was resistant to high-dose IgG. Conclusions A corticosteroid can effectively inhibit the release of HMGB1 and IL-1α, which may be involved in IVIG resistance in KD. Since high-dose IgG does not have such beneficial anti-cytotoxic effects, adding a corticosteroid to standard IVIG therapy may help prevent the progression of IVIG resistance in KD.

scholarly journals A combination therapy for Kawasaki disease with severe complications: a case report

Open Medicine ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Yuriko Abe ◽  
Mamoru Ayusawa ◽  
Kengo Kawamura ◽  
Ryuta Yonezawa ◽  
Masataka Kato ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Combination Therapy ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Left Ventricular ◽  
Slow Waves ◽  
Left Ventricular Failure ◽  
Acute Encephalopathy ◽  
Ventricular Failure ◽  
Methylprednisolone Pulse

AbstractKawasaki disease (KD) is a form of acute multisystem vasculitis that presents with various complications, including coronary artery aneurysm. Heart failure and brain damage are rare, but life-threatening complications are associated with KD. Here, we describe a 4-year-old girl who developed intravenous immunoglobulin-resistant KD with both left ventricular failure and acute encephalopathy. On day 8 of the illness, the low left ventricular ejection fraction, mitral regurgitation, and low blood pressure, which required continuous administration of dobutamine, were observed during the treatments for KD, including intravenous immunoglobulin. She also appeared unconscious, where the electroencephalogram showed slow waves of activity in all regions of the brain. The cardiac performance improved after she received plasma exchange for three days. However, her unconsciousness with slow waves of activity on electroencephalogram and fever continued after the plasma exchange. Therefore, she was treated with methylprednisolone pulse, followed by prednisolone, as well as intravenous immunoglobulin. Finally, she recovered without any cardiac or neurological sequelae not only at the time she was discharged, but also throughout the follow-up period. The combination therapy using plasma exchange and methylprednisolone pulse may be a treatment option for severe KD with left ventricular failure and acute encephalopathy complications.

scholarly journals High-dose intravenous immunoglobulin therapy induces and maintains complete remission for polyarteritis nodosa

2014 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Kazu Ode ◽  
Yoshinori Taniguchi ◽  
Yoshitaka Kumon ◽  
Yoshio Terada
Keyword(s):  
Complete Remission ◽  
Intravenous Immunoglobulin ◽  
Polyarteritis Nodosa ◽  
Alternative Therapy ◽  
Ivig Therapy ◽  
Immunoglobulin Therapy ◽  
High Dose ◽  
Intravenous Immunoglobulin Therapy ◽  
First Line Therapy ◽  
High Dose Ivig

We report a case of successful high-dose intravenous immunoglobulin (IVIG) use in a patient with refractory polyarteritis nodosa (PAN). Treatments with prednisolone (PSL) and various types of immunosuppressants including methotrexate (MTX) and intravenous cyclophosphamide (IVCY) were unsuccessful, and then, high-dose IVIG therapy was added. High-dose IVIG therapy improved all symptoms including high fever, arthralgia, mononeuritis multiplex and indurated erythema due to PAN. Moreover, serum inflammatory markers were also normalized. High-dose IVIG is maintaining complete remission for PAN without flare-up for additional 4 years. Therefore, high-dose IVIG therapy might be considered as a first-line therapy in patients with PAN or alternative therapy in refractory PAN.

scholarly journals Two Cases of Kawasaki-Disease Who Showed Coronary Arterial Dilatation Even after Good Response to a Single High-dose Intravenous Immunoglobulin Infusion

2003 ◽  
Vol 53 (1) ◽  
pp. 178-178
Author(s):  
Takashi Takeuchi ◽  
Norihiro Inoue ◽  
Takaomi Minami ◽  
Shoichi Shibuta ◽  
Hiroyuki Suzuki ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
High Dose ◽  
Single High Dose

Combined treatment with plasma exchange and high dose intravenous immunoglobulin in myasthenia gravis

1991 ◽  
Vol 4 (6) ◽  
pp. xxxi
Author(s):  
E.Díez Tejedor ◽  
J. Tejada ◽  
A. Frank ◽  
M. Lara ◽  
P. Barreiro
Keyword(s):  
Myasthenia Gravis ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Combined Treatment ◽  
High Dose

scholarly journals The Use Of Intravenous Immunoglobulin For The Treatment Of Severe Covid-19: Case Presentation For Three Patients

2021 ◽  
Author(s):  
Nuh Kumru ◽  
Saliha Yarımoğlu ◽  
Tayfun Et ◽  
Rafet Yarımoğlu ◽  
Muhammet Korkusuz
Keyword(s):  
Intravenous Immunoglobulin ◽  
Ivig Therapy ◽  
High Dose ◽  
Case Presentation ◽  
Receptor Blockers ◽  
Interleukin Receptor

Although the treatment of the hyperinflammatory response due to COVID-19 has not yet been found, high-dose corticosteroids, interleukin receptor blockers and intravenous immunoglobulin (IVIG) are used to improve the hyperinflammatory response.In this article, we aimed to share our experiences with 3 patients who received IVIG therapy in ICU.

scholarly journals A Retrospective Observational Study of Adverse Reactions Associated With Intravenous Immunoglobulin Infusion

2021 ◽  
Vol 12 ◽  
Author(s):  
Hidefumi Kato ◽  
Megumi Hayashi ◽  
Wataru Ohashi ◽  
Takamasa Yamaguchi ◽  
Satomi Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intravenous Immunoglobulin ◽  
Neuromuscular Disease ◽  
Adverse Reactions ◽  
Ivig Therapy ◽  
High Dose ◽  
Adult Age ◽  
Patient Demographics ◽  
Dosing Regimens ◽  
Design And Methods

BackgroundAlthough intravenous immunoglobulin (IVIG) therapy is generally safe and well tolerated, adverse reactions (ARs) do occur. The majority of these ARs are mild and transient. Risk factors for ARs associate with IVIG infusions are not well established. This study investigated possible risk factors influencing the occurrence of IVIG-associated ARs.Study Design and MethodsThis was a retrospective observational analysis of data accumulated over 5 years, including patient demographics, clinical condition, IVIG dosing regimens, number of IVIG infusions, and any ARs.ResultsARs were associated with IVIG in 4.9% of patients and 2.5% of infusions. By univariate analyses, ARs correlated with female sex, adult age, high dose IVIG, and autoimmune disease. Multivariate logistic regression identified three statistically significant of risk factors: on a per-patient basis, being female (p=0.0018), having neuromuscular disease (p=0.0002), and receiving higher doses of IVIG per patient body weight (p<0.001), on a per-infusion basis, being female (p < 0.001), being adolescents to middle age (p < 0.001), and having neuromuscular disease (p < 0.001).ConclusionNeuromuscular disease emerged as one of the significant factors for ARs to IVIG.

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