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The Clinical Significance of Soluble Intercellular Adhesion Molecule-1(sICAM-1) and Soluble Vascular Cell Adhesion Molecule-1(sVCAM-1) in Kawasaki Disease

Korean Journal of Pediatrics 2005;48(6):640-648.
Published online June 15, 2005.
The Clinical Significance of Soluble Intercellular Adhesion Molecule-1(sICAM-1) and Soluble Vascular Cell Adhesion Molecule-1(sVCAM-1) in Kawasaki Disease
Kang Won Rhee1, Sin Weon Yun1, Dong Keun Lee1, Eung Sang Choi1, Byung Hoon Yoo1, Mi Kyung Lee2
1Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea
2Department of Laboratory Medicine, College of Medicine, Chung-Ang University, Seoul, Korea
급성 발열기 및 아급성기 가와사끼병에서 세포부착분자 sICAM-1, sVCAM-1의 임상적 의의
이강원1, 윤식원1, 이동근1, 최응상1, 유병훈1, 이미경2
1중앙대학교 의과대학 소아과학교실
2중앙대학교 의과대학 진단검사의학교실
Correspondence: 
Sin Weon Yun, Email: yswmd@cau.ac.kr
Abstract
Purpose
: Kawasaki disease(KD) is known as an acute multi-systemic vasculitis with various immunologic abnormalities. Adhesion of leukocyte to endothelial cells is a key event in the sequence of inflammatory response. This study was performed to investigate the clinical significance of serum soluble intercellular adhesion molecule-1(sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in acute and subacute stages of typical KD for diagnostic and prognostic value.
Methods
: A typical KD group was 32 patients who were hospitalized from Jan. 2002 to Jun. 2004 was enrolled. Control was 16 non-KD patients with febrile illness. sICAM-1 and sVCAM-1 were measured and compared by Echocardiographic and clinical findings and cardiac troponin T and I.
Results
: sICAM-1 and sVCAM-1 levels of acute KD were significantly elevated over control(P= 0.019 vs. P=0.049, respectively) and sICAM-1 was significantly decreased in subacute stage(P= 0.0015). sICAM-1 and sVCAM-1 had positive correlation with each other in both stages(P=0.0067, P=0.015, retrospectively). Neither sICAM-1 nor sVCAM-1 correctly reflected the coronary abnormalities and responsiveness to intravenous gammaglobulin(IVGG) in both stages. But sVCAM-1 was significantly increased in the carditis group in both stages(P=0.025, P=0.014, retrospectively) and had a positive correlation with troponin T(r=0.63, P=0.00063).
Conclusion
: The levels of sICAM-1 and sVCAM-1 were not very useful tools for detecting and predicting subsequent coronary abnormalities and responsiveness to IVGG in KD patients. However, sVCAM-1 appears to play a significant role in carditis of KD. Further studies are needed about various adhesion molecules and cytokines in the pathogenesis of KD.
Key Words: Kawasaki disease , ICAM-1 , VCAM-1 , Coronary disease , Carditis


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