Kawasaki disease (KD) is an acute febrile childhood inflammatory disease, associated with coronary artery abnormalities. The disease is believed to result from an aberrant inflammatory response to an infectious trigger in a genetically predisposed individual. KD is associated with an endothelial cell injury as a consequence of T cell activation and cytotoxic effects of various proinflammatory cytokines. Intravenous immunoglobulin (IVIG) infusion and aspirin are the standard treatment of acute KD. However, 10-20% of patients show resistance to IVIG therapy and present higher risk of coronary vasculitis. The relative roles of second IVIG infusion, corticosteroids, calcineurin inhibitors, interleukin-1 antagonists and anti-tumor necrosis factor agents remain uncertain. In this review, we highlight the predisposing factors, pathogenesis and therapeutic intervention of KD, particularly new therapeutics for IVIG-resistant patients.
Predisposing factors, pathogenesis and therapeutic intervention of Kawasaki disease / C. Galeotti, S.V. Kaveri, R. Cimaz, I. Koné-Paut, J. Bayry. - In: DRUG DISCOVERY TODAY. - ISSN 1359-6446. - 21:11(2016 Nov), pp. 1850-1857. [10.1016/j.drudis.2016.08.004]
Predisposing factors, pathogenesis and therapeutic intervention of Kawasaki disease
R. Cimaz;
2016
Abstract
Kawasaki disease (KD) is an acute febrile childhood inflammatory disease, associated with coronary artery abnormalities. The disease is believed to result from an aberrant inflammatory response to an infectious trigger in a genetically predisposed individual. KD is associated with an endothelial cell injury as a consequence of T cell activation and cytotoxic effects of various proinflammatory cytokines. Intravenous immunoglobulin (IVIG) infusion and aspirin are the standard treatment of acute KD. However, 10-20% of patients show resistance to IVIG therapy and present higher risk of coronary vasculitis. The relative roles of second IVIG infusion, corticosteroids, calcineurin inhibitors, interleukin-1 antagonists and anti-tumor necrosis factor agents remain uncertain. In this review, we highlight the predisposing factors, pathogenesis and therapeutic intervention of KD, particularly new therapeutics for IVIG-resistant patients.File | Dimensione | Formato | |
---|---|---|---|
predisposing factors 2016.pdf
accesso riservato
Tipologia:
Publisher's version/PDF
Dimensione
533.86 kB
Formato
Adobe PDF
|
533.86 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
main.pdf
accesso riservato
Tipologia:
Publisher's version/PDF
Dimensione
570.18 kB
Formato
Adobe PDF
|
570.18 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.