All issues > Volume 48(6); 2005

Original Article

Korean J Pediatr. 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 KW Rhee¹, Sin Weon SW Yun¹, Dong Keun DK Lee¹, Eung Sang ES Choi¹, Byung Hoon BH Yoo¹, Mi Kyung MK Lee²

¹Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea
²Department of Laboratory Medicine, College of Medicine, Chung-Ang University, Seoul, Korea

Correspondence Sin Weon SW 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.

Keywords :Kawasaki disease , ICAM-1 , VCAM-1 , Coronary disease , Carditis