| Objective:To explore the expression of VEGF，ES，HSP60and HSP70inacute phase and convalescence in Kawasaki Disease and the relationshipbetween HSP60and HSP70during the development of KD.And discusstheir expression in the coronary artery lesion（CAL）with KD,thus toprovide some theory evidence for prevention the CAL.Method:1. Serum collection（1）Work group:The serum was collectedfrom25KD children（10patients with coronary arterial lesions,groupCAL;and15patients with no coronary arterial lesions,group NCAL.）with KD in the acute phase（pathogenesis1-2weeks,before IVIG）andconvalescence phase（pathogenesis3-4weeks, after IVIG）.（2）Controlgroup:20children with febrility（group F）and20normal children（groupC）.2. Detect index:The levels of VEGF，ES，HSP60and HSP70weredetected by Enzyme-linked immunosorbent assay（ELISA） in serum.3. Statistical analysis:Statistical anaylsis was peformed usingthe statistical programs SPSS17.0, data were expressed asaverage±standard devidation. Comparison between groups use one-wayanalysis of variance,and comparison between two groups use LSD test.The ratio of VEGF/ES uses rank test. The correlation analysis with VEGF and ES to adopt Bivariate.Size of test is0.05（bilateral）.P values less than0.05is considered to be statistical significance.Result:1. VEGF, ES and VEGF/ES：（1）Before IVIG therapy serum VEGF is （1123.82±80.31pg/ml）, issignificantly elevated in KD than that in work group after IVIG therapy,group F and group C（P＜0.01）.After IVIG therapy serum VEGF level is（1123.82±80.31pg/ml）, is significantly elevated in KD than that ingroup F and group C（P＜0.01）.（2）Before IVIG therapy serum ES is（173.23±5.41ng/ml）, is significantly lower in KD than that in group F（P<0.05）and group C（P＜0.01）. Before IVIG therapy serum EScompared with work group after IVIG therapy （180.44±6.03ng/ml）,there is no statistical significance（P＞0.05）.（3）After IVIGtherapy serum ES level is（180.44±6.03ng/ml）, is significantly lower inKD than that in group F and group C（P＜0.05）.（4）Before IVIG therapyserum VEGF/ES is(6.89±1.02×10-3), is significantly elevated in KDthan that in work group after IVIG therapy, group F and group C（P＜0.01）. After IVIG therapy serum VEGF/ES level is(3.95±0.76×10-3),is significantly elevated in KD than that in group F and group C（P＜0.01）.（5）The level of VEGF（306.43±67.92pg/ml），ES（188.17±5.25ng/ml） and VEGF/ES(1.64±0.20×10-3)in group F, compared withgroup C VEGF（244.65±69.10pg/ml）,ES（195.30±5.84ng/ml） andVEGF/ES(1.26±0.18×10-3),there are no statistical significance（P＞ 0.05）.（6）VEGF of group CAL is（1260.23±82.65pg/ml）, VEGF/ESof group CAL i(s6.91±0.88×10-3),compared with group NCAL VEGF is（976.54±76.30pg/ml）, VEGF/ES is (4.12±0.65×10-3),aresignificantly higher than that in group NCAL（P＜0.01）.ES of groupCAL is（168.42±8.40ng/ml），compared with group NCAL ES is（188.54±7.85ng/ml）,is significantly lower than that in group NCAL（P＜0.01）.2. Associativity analysis with VEGF and ES: There are significantnegative correlations between VEGF and ES levels in KD patients beforeIVIG therapy （r=-0.642，P<0.01）and after IVIG therapy（r=-0.806，P<0.01）.3. HSP60,HSP70（1）Before IVIG therapy serum HSP60is （4557.30±432.71pg/ml）, issignificantly elevated in KD than that in work group after IVIG therapy,group F and group C（P＜0.01）.（2）Before IVIG therapy serum HSP70is （4633.28±679.33pg/ml）, is significantly elevated in KD than that inwork group after IVIG therapy, group F and group C（P＜0.01）.（3）After IVIG therapy serum HSP60level is（3987.43±378.95pg/ml）,compared with group F and group C,there are no statistical significance（P＞0.05）.（4）After IVIG therapy serum HSP70level is（4027.14±595.25pg/ml）, is significantly higher in KD than that ingroup F and group C （P＜0.01）.（5） The level of HSP60 （3894.50±564.33pg/ml）,HSP70（3410.15±674.10pg/ml）in group F,compared with group C HSP60（3871.23±489.40pg/ml）,HSP70（3396.50±639.23pg/ml）,there are no statistical significance（P＞0.05）.（6）HSP60of group CAL is（4779.34±564.31pg/ml）,compared withgroup NCAL HSP60is（3874.27±478.37pg/ml）, is significantly higherthan that in group NCAL （P＜0.01）. HSP70of group CAL is（3569.37±603.34pg/ml），compared with group NCAL HSP70is（4899.40±637.21pg/ml）,is significantly lower than that in groupNCAL（P＜0.05）.Conclusion:1.VEGF, VEGF/ES increas significantly before IVIGtherapy.Although both of them has dropped after IVIG therapy, but arestill in a relatively high level. And the acute phase ES reduce significantly,and is still in a low level after IVIG therapy. VEGF, VEGF/ES in serumin group CAL are significantly higher than that in group NCAL, but ES inserum in group CAL is significantly lower than that in groupNCAL.Suggesting that VEGF, ES, VEGF/ES are not only involved inthe early vascular damage process of KD, but also involved in the lastingcoronary damage. These findings suggest that VEGF/ES in serum mightbe risk factors of KD coronary artery lesion,which may play animportant role in KD with vessle wall damage and CAL,but ES mighthave the function of a coronary artery damage inhibition.2. There are significant negative correlations between VEGF and ES levels in KD patients before IVIG therapy （r=-0.642，P<0.01）and afterIVIG therapy（r=-0.806，P<0.01）. These findings indicate ES in a certainextent to suppress the role of VEGF in the course of the KD,which mayhave the function of a coronary artery damage inhibition.And the balancebetween VEGF and ES are involved in the reconstruction of the bloodvessel walls.3. HSP60,HSP70increased significantly before IVIG therapy, but HSP60has dropped significantly and HSP70is still in a relatively high level afterIVIG therapy. HSP60in serum in group CAL is significantly higher thanthat in group NCAL, HSP70in serum in group CAL is significantly lowerthan that in group NCAL. These findings suggest HSP60is as adangerous factors in CAL and has relationship with “Antigens simulationtheory”; HSP70may be as a protection factors in CAL to suppress theoccurrence of blood vessels inflammatory reaction. HSP60,HSP70increased significantly before IVIG therapy,suggesting both of them areactively participate in blood vessels inflammatory reaction in KD acuteperiod,and HSP60promotes blood vessel inflammation but HSP70inhibits it. HSP70is still in a relatively high level after IVIGtherapy,which indicates HSP70to the inhibition of the inflammatoryresponse could last until the course of recovery. |
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