Circulating Endothelial Cells And RAGE On The Surface Of Circulating Endothelial Cells In Children With Kawasaki Disease

【Objective】Kawasaki disease is an acute vasculitis syndrome primarily affecting small and medium-sized arteries,especially coronary artery.At present,the disease has replaced rheumatic fever as the first reason for acquired heart disease in China and many countries of the world.The etiology and mechanism of coronary artery lesions in Kawasaki disease has not been clear.Intravenous immunoglbobulin(IVIG) can reduce coronary artery lesions effectively,but 10%of patients is IVIG non-response.In recent years,Circulating endothelial cells(CECs),S100A12 and RAGE have aroused the attention of scholars.In order to clarify the relationship of circulating endothelial cells, RAGE and Kawasaki disease,we studied the circulating endothelial cells and RAGE expression on surface of circulating endothelial cells in the acute phase,sub-acute phase and recovery phase of Kawasaki disease.Also we investigated the relationship of CECs and RAGE with the IVIG non-response and coronary artery lesions.【Material and Metheds】1.Experimental group:1.1.Control group:a total of 38 children of health check,from Dec 2008 to Jul 2009 in the Children's Hospital,Zhejiang University School of Medicin. 1.2.Kawasaki disease group:a total of 79 cases,from Dec 2008 to Jul 2009 in the Children's Hospital,Zhejiang University School of Medicin,were diagnosed as Kawasaki disease and traeted by IVIG.They were divided into two groups:①IVIG Non-response group was 5 cases;②Coronary Artery Lesions group was 11 cases.2.Flow cytometry:monoclonal antibodies and flow cytometry were used to detect the circulating endothelial cells/monocyte,RAGE-positive rate,RAGE fluorescence intensity.【Result】1.The circulating endothelial cell/monocyte,RAGE-positive rate,RAGE fluorescence intensity were 1.45±0.54,26.66±10.16 and 31.29±11.55 in acute phase;1.41±0.49, 23.87±6.36 and 30.04±8.95 in sub-acute phase;1.39±0.49,25.17±9.93 and 28.98±8.52 in recovery phase of Kawasaki disease;0.95±0.39,17.71±4.52 and 21.47±4.26 in control group.The levels of circulating endothelial cell/monocyte, RAGE-positive rate and RAGE fluorescence intensity were significantly(P＜0.05) higher in kawasaki disease than in control.2.The circulating endothelial cell/monocyte,RAGE-positive rate,RAGE fluorescence intensity were 1.38±0.65,24.42±12.87 and 26.58±7.75 in acute phase;1.58±0.58, 26.50±6.81 and 33.41±13.84 in sub-acute phase;1.23±0.45,31.97±15.31 and 38.67±12.34 in recovery phase of IVIG Non-response group.The levels were significantly(P＜0.05) higher in IVIG Non-response group than in control.3.The circulating endothelial cell/monocyte,RAGE-positive rate,RAGE fluorescence intensity were 1.40±0.49,26.71±6.80 and 27.56±6.17 in acute phase;1.38±0.59, 26.61±6.84 and 27.53±8.30 in sub-acute phase;1.25±0.50,28.41±13.64 and 29.73±8.99 in recovery phase of coronary artery lesions group.The levels were significantly(P＜0.05) higher in coronary artery lesions group than in control.4.The circulating endothelial cell/monocyte,RAGE-positive rate,RAGE fluorescence intensity were 1.43±0.54,26.15±9.93 and 36.12±43.37 in acute phase;1.40±0.48, 23.65±7.82 and 29.91±8.65 in sub-acute phase;1.40±0.48,24.14±8.80 and 27.62±7.04 in recovery phase of IVIG-sensitive group;There was no significant difference compared with IVIG Non-response group(P＞0.05).5.The circulating endothelial cell/monocyte,RAGE-positive rate,RAGE fluorescence intensity were 1.43±0.54,26.01±10.21 and 36.99±45.34 in acute phase;1.44±0.49, 23.62±7.98 and 30.21±8.86 in sub-acute phase;1.38±0.50,23.45±8.12 and 27.80±7.44 in recovery phase of without coronary artery lesions group;There was no significant difference compared with coronary artery lesions group(P＞0.05).【Conclusion】The circulating endothelial cells/monocyte,RAGE-positive rate and RAGE fluorescence intensity increase throughout the course of Kawasaki disease.It indicates that circulating endothelial cells and RAGE play an important role for Kawasaki disease, but their levels can not predict whether the IVIG non-response or coronary artery lesions.