All issues > Volume 47(6); 2004

Original Article

Korean J Pediatr. 2004;47(6):656-664. Published online June 15, 2004.

Matrix Metalloproteinases, Tissue Inhibitors and Cytokines in Patients with Kawasaki Disease

Ae Ra AR Cho¹, Young Mi YM Hong¹

¹Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea

Correspondence Young Mi YM Hong ,Email: hongym@chollian.net

Abstract

Purpose
: Kawasaki disease(KD) is a multisystemic inflammatory vasculitis of unknown etiology, but immunological abnormalities have been documented and implicated in the pathogenesis of KD. Matrix metalloproteinases(MMPs) have proteolytic activity against connective tissue proteins, and increased activity of MMPs and a quantitative imbalance between MMP and tissue inhibitor of MMP (TIMP) can result in several pathologic conditions. MMP and TIMP may also be involved in the formation of coronary arterial lesions in KD.
Methods
: Serum levels of MMP1, MMP2, MMP9, TIMP1, TIMP2, interleukin(IL)-6 and tumor necrosis factor(TNF)-α were measured in 27 KD patients(group I, 10 patients with normal coronary artery; group II, 17 patients with coronary arterial lesions) and 15 healthy children(group III). Blood samples from each study group were drawn before and after intravenous immunoglobulin(IVIG) therapy and in the convalescent stage.
Results
: The MMP9 levels and MMP9/TIMP2 ratios before and after IVIG therapy were significantly higher in group II. The MMP9 levels were significantly higher before IVIG therapy, and decreased through the convalescent stage. The IL-6 and TNF-α levels were also significantly higher in group II than in the other groups. The serum MMP9 levels showed significantly positive correlation with the circulating leukocyte counts and IL-6 levels.
Conclusion
: The increased levels of MMP and the imbalance between MMP and TIMP increase the susceptibility to the coronary arterial lesions in KD. The cytokines including IL-6 and TNF-α are also important in the activation of MMP and formation of coronary arterial lesions in KD.

Keywords :Mucocutaneous lymph node syndrome, Matrix metalloproteinases, Tissue inhibitor of matrix metalloproteinases, Cytokines