Relations Between S100A12, Soluble RAGE In Serum And Kawasaki Disease

Objective:Kawasaki disease is an acute self-limited vasculitis of childhood, and it has surpassed acute rheumatic fever as the leading cause of acquired heart disease in children. The etiology of Kawasaki disease remains unknown. The calcium-binding protein S100A12 causes inflammation through interaction with the multiligand receptor for advanced glycation end products (RAGE). We previously showed that the expression of protein S100A12 and sRAGE were enhanced on the circulating endothelial cells. This result indicated that sRAGE, RAGE and protein S100A12 could be used as additional serum marker for Kawasaki disease. So the expression of protein S100A12 and sRAGE were studied to further investigate the roles of S100A12-RAGE pathway in the pathogenesis of Kawasaki disease, and whether protein S100A12/sRAGE were involved in IVIG resistant and coronary artery lesions.Methods:We measured the serum protein S100A12 and sRAGE levels in KD subjects and healthy children as control with enzyme-link immunosorbent assay (ELISA). All the cases were collected from February 2010 to July 2010. Inpatients with Kawasaki disease in the Children's Hospital of Zhejiang University School of Medicine were selected. All of them were treated by IVIG. The diagnostic criteria of Kawasaki disease was according to the Seventh International Kawasaki Disease Symposium (Japan Hakone,2002).Results:The value of protein S100A12 in serum of KD children was increased markedly than those of the normal control group in acute phase and 3 days after body temperature declined to normal. While the value of sRAGE in serum of KD children was significantly lower than those of the normal control group in acute phase,3 days after body temperature declined to normal and in subacute phase. The rate of protein S100A12 and sRAGE was decreasing as time went by. The level of sRAGE was higher in boys than that in girls, and the expression of sRAGE was significant enhanced with age increasing. IVIG can adjust the expression of protein S100A12. The level of protein S100A12 was enhanced in IVIG resistance group.Conclusion:The interaction of protein S100A12 and sRAGE was found each period of Kawasaki disease. The expression of protein S100A12 was decreased with time, while sRAGE was increased. The level of sRAGE was higher in boys than that in girls, and significant enhanced with age increasing. For those who have higher level of protein S100A12 and lower lever of sRAGE in subacute phase with KD, we should be aware of the possibility of IVIG resistant. For those who have lower level of protein S100A12 and higher lever of sRAGE in acute phase, we should be aware of the possibility of coronary artery lesions.