J Korean Pediatr Cardiol Soc.  2006 Sep;10(3):299-308.

Hepatocyte Growth Factor, Vascular Endothelial Growth Factor and Tumor Necrosis Factor-Alpha in Patients with Kawasaki Disease

• Joo SY
• Hong YM

Abstract

PURPOSE: Kawasaki disease (KD) is a multisystemic inflammatory vasculitis. Cytokines and growth factors have been implicated in the development of coronary lesions in KD. Hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) are thought to stimulate endothelial cell proliferation and induce angiogenesis in vivo. However, the precise mechanism of how HGF and VEGF produce coronary artery disease in children is still unknown. We measured serum levels of HGF, VEGF and tumor necrosis factor-alpha (TNF-alpha) in KD and investigated the association of these factors with the development of coronary artery lesions.
METHODS
Serum levels of HGF, VEGF and TNF-alpha were measured in 24 KD patients (group 1, 8 patients with normal coronary artery; group 2, 16 patients with coronary artery lesions) and 21 controls (group 3, 10 afebrile controls; group 4, 11 febrile controls). Blood samples from each study subjects were drawn before and after intravenous immunoglobulin (IVIG) therapy and in the convalescent stage.
RESULTS
The HGF levels before IVIG therapy were significantly higher in group 1 and 2 than in group 3 (P<0.05). The VEGF levels were significantly higher in group 1 and 2 than group 3 and 4 (P<0.05). The TNF-alpha levels before IVIG therapy were significantly higher in group 1 and 2 than group 3 and 4 (P<0.05). Serial serum levels of HGF, VEGF and TNF-alpha in KD patients with coronary artery lesions were high before IVIG therapy and decreased after IVIG therapy and in the convalescent stage. In the acute KD patients with coronary artery lesions serum VEGF levels correlated significantly with TNF-alpha levels (r=0.456).
CONCLUSION
Serum HGF, VEGF and TNF-alpha levels can be used as a valuable marker not only for early diagnosis of Kawasaki disease, but also for differential diagnosis of other febrile diseases.

Keyword

Kawasaki disease; Hepatocyte growth factor; Vascular endothelial growth factor; Tumor necrosis factor-alpha

MeSH Terms

Child
Coronary Artery Disease
Coronary Vessels
Cytokines
Diagnosis, Differential
Early Diagnosis
Endothelial Cells
Hepatocyte Growth Factor*
Hepatocytes*
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Intercellular Signaling Peptides and Proteins
Mucocutaneous Lymph Node Syndrome*
Tumor Necrosis Factor-alpha*
Vascular Endothelial Growth Factor A*
Vasculitis
Cytokines
Hepatocyte Growth Factor
Immunoglobulins
Immunoglobulins, Intravenous
Intercellular Signaling Peptides and Proteins
Tumor Necrosis Factor-alpha
Vascular Endothelial Growth Factor A