Tight junction protein ZO-1 in Kawasaki disease.
BACKGROUND
Kawasaki disease (KD) is a form of systemic febrile vasculitis that is complicated with coronary artery lesions (CAL). The tight junctions that maintain the intestinal barrier also play a role in systemic inflammatory diseases. Serum zonula occludens-1 (ZO-1) expression was found to be significantly lower in asthmatic patients, and another study reported that elevated systemic ZO-1 was positively correlated with inflammation in cirrhotic patients. A murine model of KD vasculitis demonstrated that vasculitis depended on intestinal barrier dysfunction, which is maintained by tight junctions. In this study, we aimed to investigate the role of the tight junction zonula occludens-1 (ZO-1) in the treatment response of intravenous immunoglobulin (IVIG) and the occurrence of CAL formation in KD patients.


METHODS
We enrolled 40 KD patients, 12 healthy controls, and 12 febrile controls in this study. The serum levels of tight junction ZO-1 were determined by enzyme-linked immunosorbent assay.


RESULTS
The serum ZO-1 level was higher in the fever control group but did not reach a statistical significance. KD patients who received a second dose of IVIG treatment due to initial IVIG unresponsiveness had a higher serum levels of tight junction ZO-1, but without statistical significance (2.15 ± 0.18 vs. 2.69 ± 0.31 ng/mL, p = 0.058). KD patients who developed a CAL demonstrated a significant lower serum tight junction ZO-1 levels than KD without CAL formation (1.89 ± 0.16 vs. 2.39 ± 0.15 ng/mL, p = 0.027). After multiple logistic regression analysis, ZO-1 levels [(95% confidence interval (CI): 0.058 ~ 0.941, odds ratio (OR) = 0.235, p = 0.041)] showed as the risk factor for CAL formation.


CONCLUSION
Serum levels of tight junction ZO-1 levels were lower in KD patients than fever controls and associated with CAL formation.
['Lai|Wan-Tz|WT|', 'Lee|Hung-Chang|HC|', 'Huang|Ying-Hsien|YH|', 'Lo|Mao-Hung|MH|', 'Kuo|Ho-Chang|HC|0000-0002-3295-2984']
D000818:Animals D003331:Coronary Vessels D006801:Humans D016756:Immunoglobulins, Intravenous D051379:Mice D009080:Mucocutaneous Lymph Node Syndrome D019108:Tight Junctions D062826:Zonula Occludens-1 Protein
Tight junction protein Kawasaki disease Coronary artery lesions