Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Coronary Arterial Lesions of Kawasaki Disease Observed in a Mouse Model of Sepsis: A Pilot Study and a Review of the Literature

패혈증 마우스 모델에서 가와사키병의 관상동맥 병변 관찰: 예비연구와 문헌고찰

  • Kim, Joo-Hyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyo-Jin (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Shin, Jung-Ha (Department of Pathology, College of Medicine, The Catholic University of Korea) ;
  • Choi, Ui-Yoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Lee, Soo-Young (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Han, Ji-Whan (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • 김주현 (가톨릭대학교 의과대학 소아과학교실) ;
  • 김효진 (가톨릭대학교 의과대학 소아과학교실) ;
  • 신정하 (가톨릭대학교 의과대학 병리학교실) ;
  • 최의윤 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이수영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 한지환 (가톨릭대학교 의과대학 소아과학교실)
  • Received : 2016.09.17
  • Accepted : 2016.10.24
  • Published : 2017.08.25
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Abstract

Purpose: Coronary arterial lesions (CALs) were reported to have developed in children with systemic inflammatory diseases, as well as those with Kawasaki disease (KD). The purpose of this study was to confirm that the CAL development in children with KD occurs in a mouse model of sepsis presenting typical systemic inflammatory response syndrome (SIRS). Methods: To induce the sepsis mouse model with SIRS, 6-week-old C57BL/6 mice were intraperitoneally injected with endotoxin. We compared histological findings of the major organs between the control and the sepsis groups and examined CAL in the heart of the septic mice. Results: Infiltrating inflammatory cells were relatively increased in the heart, liver, and kidneys of the sepsis group, compared with those of the control group. We confirmed lymphocytic infiltration in the myocardium (myocarditis) and the pericardial soft tissue of the heart. Furthermore, coronary artery of the septic mouse was identified, but CAL was not observed. Conclusions: In this study, we failed to confirm the existence of CAL in a mouse model of sepsis. However, it is well-known that CALs are seen in many kinds of diseases that cause SIRS. Our findings suggest further investigation into the clinical significance of CAL in various systemic inflammatory diseases, including KD.

목적: 가와사키병의 환아뿐만 아니라, 다른 전신 염증 질병의 환아들에 관상동맥 병변(coronary arterial lesion [CAL])의 발생이 보고되었다. 본 연구에서는 전형적인 전신염증반응증후군(systemic inflammatory response syndrome [SIRS])의 소견을 보이는 패혈증 마우스 모델에서 가와사키병 환아에게 관찰되는 CAL이 발생하는지 확인하고자 하였다. 방법: 생후 6주 C57BL/6 마우스에 내독소를 복강내주사하여 SIRS를 보이는 패혈증 모델을 유도하였다. 대조군과 패혈증군의 주요 장기의 조직학적 소견을 비교하였고 패혈증 마우스에서 CAL을 찾기 위한 시도를 하였다. 결과: 대조군과 비교하여, 염증세포의 침윤이 패혈증 마우스의 심장, 간, 신장에 상대적으로 증가하였다. 패혈증 마우스의 심장에서 심근(심근염)과 심장 주위 연조직에 림프구 침윤을 확인하였다. 또한, 패혈증 마우스의 관상동맥을 관찰하였지만, CAL을 확인할 수는 없었다. 결론: 본 연구에서 패혈증 마우스 모델에서 CAL의 존재를 확인하는 것은 실패하였다. 하지만, SIRS를 유발하는 많은 종류의 원인 질병에서 CAL이 발생한다는 것은 잘 알려져 있다. 가와사키병을 포함한 다양한 전신 염증 질병에 나타나는 CAL의 임상적 의미에 대한 연구가 필요할 것이다.

Keywords

References

  1. Kaplan SL, Vallejo JG. Bacteremia and septic shock. In: Cherry JD, Demmler-Harrison GJ, Kaplan SL, Steinbach WJ, Hotez P, editors. Feigin and Cherry's textbook of pediatric infectious diseases. 7th ed. Philadelphia: Saunders/Elsevier, 2014;824-36.
  2. Lee SY, Lee KH, Hwang HS, Jeong DC, Chung SY, Kang JH. Septic encephalopathy complicating acute appendicitis. Pediatr Crit Care Med 2009;10:e11-3. https://doi.org/10.1097/PCC.0b013e3181937125
  3. Zanotti-Cavazzoni SL, Goldfarb RD. Animal models of sepsis. Crit Care Clin 2009;25:703-19. https://doi.org/10.1016/j.ccc.2009.08.005
  4. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110:2747-71. https://doi.org/10.1161/01.CIR.0000145143.19711.78
  5. Yun HW, Lee JY, Yang SI, Yu HJ, Kang MJ, Lee SY, et al. Comparison of cervical-lymph-node-first presentation of Kawasaki disease and typical Kawasaki disease. Pediatr Infect Vaccine 2016;23:10-7. https://doi.org/10.14776/piv.2016.23.1.10
  6. Park HJ, Cho YJ, Bae EY, Choi UY, Lee SY, Jeong DC, et al. Macrophage activation syndrome as the extreme form of Kawasaki disease. Korean J Pediatr Infect Dis 2010;17:177-81. https://doi.org/10.14776/kjpid.2010.17.2.177
  7. Lee SY, Han JW. Animal model of Kawasaki disease. Pediatr Clin Immunol 2012;4:46-9.
  8. Rached-D'Astous S, Boukas I, Fournier A, Raboisson MJ, Dahdah N. Coronary artery dilatation in viral myocarditis mimics coronary artery findings in Kawasaki disease. Pediatr Cardiol 2016;37:1148-52. https://doi.org/10.1007/s00246-016-1411-x
  9. Binstadt BA, Levine JC, Nigrovic PA, Gauvreau K, Dedeoglu F, Fuhlbrigge RC, et al. Coronary artery dilation among patients presenting with systemic-onset juvenile idiopathic arthritis. Pediatrics 2005;116:e89-93. https://doi.org/10.1542/peds.2004-2190
  10. Agarwal A, Biglarian S, Lim-Stavros S, Votava-Smith JK, Ramanathan A. Pediatric systemic lupus erythematosus presenting with coronary arteritis: a case series and review of the literature. Semin Arthritis Rheum 2015;45:42-7. https://doi.org/10.1016/j.semarthrit.2015.02.013
  11. Gatterre P, Oualha M, Dupic L, Iserin F, Bodemer C, Lesage F, et al. Kawasaki disease: an unexpected etiology of shock and multiple organ dysfunction syndrome. Intensive Care Med 2012;38:872-8. https://doi.org/10.1007/s00134-012-2473-8
  12. Vodovotz Y, Chow CC, Bartels J, Lagoa C, Prince JM, Levy RM, et al. In silico models of acute inflammation in animals. Shock 2006;26:235-44. https://doi.org/10.1097/01.shk.0000225413.13866.fo
  13. von Drygalski A, Furlan-Freguia C, Ruf W, Griffin JH, Mosnier LO. Organ-specific protection against lipopolysaccharide-induced vascular leak is dependent on the endothelial protein C receptor. Arterioscler Thromb Vasc Biol 2013;33:769-76. https://doi.org/10.1161/ATVBAHA.112.301082
  14. Wang D, Chen Y, Jiang J, Zhou A, Pan L, Chen Q, et al. Carvedilol has stronger anti-inflammation and anti-virus effects than metoprolol in murine model with coxsackievirus B3-induced viral myocarditis. Gene 2014;547:195-201. https://doi.org/10.1016/j.gene.2014.06.003
  15. Takahashi K, Oharaseki T, Wakayama M, Yokouchi Y, Naoe S, Murata H. Histopathological features of murine systemic vasculitis caused by Candida albicans extract: an animal model of Kawasaki disease. Inflamm Res 2004;53:72-7. https://doi.org/10.1007/s00011-003-1225-1
  16. Moon HS, Huh JS, Kim MK, Lambert MM. Kawasaki disease with influenza A virus and Mycoplasma pneumoniae infections: a case report and review of literature. Pediatr Infect Vaccine 2016;23:149-54. https://doi.org/10.14776/piv.2016.23.2.149
  17. Kato S, Yoshimura K, Tanabe Y, Kimata T, Noda Y, Kawasaki H, et al. A child with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis complicated by coronary artery lesion mimicking Kawasaki disease. J Pediatr Hematol Oncol 2013;35:e317-9. https://doi.org/10.1097/MPH.0b013e31828e5281
  18. Usta Guc B, Cengiz N, Yildirim SV, Uslu Y. Cytomegalovirus infection in a patient with atypical Kawasaki disease. Rheumatol Int 2008;28:387-9. https://doi.org/10.1007/s00296-007-0440-4
  19. Boukas I, Dahdah N, Robitaille Y, Fournier A. Coronary artery dilatation and vasculitis in a case of rabies: similarity with Kawasaki disease? Pediatr Int 2013;55:237-40. https://doi.org/10.1111/j.1442-200X.2012.03655.x
  20. Hasan A, McDonough KH. The effects of Escherichia coli sepsis and short-term ischemia on coronary vascular reactivity and myocardial function. Shock 1997;8:305-10. https://doi.org/10.1097/00024382-199710000-00011
  21. Wiesenthal AM, Todd JK. Toxic shock syndrome in children aged 10 years or less. Pediatrics 1984;74:112-7.
  22. Yim D, Ramsay J, Kothari D, Burgner D. Coronary artery dilatation in toxic shock-like syndrome: the Kawasaki disease shock syndrome. Pediatr Cardiol 2010;31:1232-5. https://doi.org/10.1007/s00246-010-9771-0
  23. Gunal N, Baysal K, Haciomeroglu P, Belet N, Kolbakir F. Rheumatic heart disease and coronary vasculitis in children. Acta Paediatr 2006;95:118-20.
  24. Ouali S, Kacem S, Ben Fradj F, Gribaa R, Naffeti E, Remedi F, et al. Takayasu arteritis with coronary aneurysms causing acute myocardial infarction in a young man. Tex Heart Inst J 2011;38:183-6.
  25. Gurkan U, Kaya A, Tatlisu MA, Avsar S. A case report of coronary artery aneurysm in a patient with Behcet's disease. Turk Kardiyol Dern Ars 2014;42:651-4. https://doi.org/10.5543/tkda.2014.44202
  26. Christou A, Patsilinakos S, Chinofoti I, Marinakos A, Nikolaou N, Spanodimos S. Acute myocardial infarction in a patient with coronary artery aneurysm and Crohn's disease. Hellenic J Cardiol 2012;53:400-2.
  27. Perez-Colon E, Dadlani GH, Wilmot I, Miller M. Mesalamineinduced myocarditis and coronary vasculitis in a pediatric ulcerative colitis patient: a case report. Case Rep Pediatr 2011;2011:524364.
  28. Serrano R, Martinez MA, Andres A, Morales JM, Samartin R. Familial mediterranean fever and acute myocardial infarction secondary to coronary vasculitis. Histopathology 1998;33:163-7. https://doi.org/10.1046/j.1365-2559.1998.00462.x
  29. Ward EV, Nazari J, Edelman RR. Coronary artery vasculitis as a presentation of cardiac sarcoidosis. Circulation 2012;125:e344-6. https://doi.org/10.1161/CIRCULATIONAHA.110.990747
  30. Kuo HC, Chang JC, Guo MM, Hsieh KS, Yeter D, Li SC, et al. Gene-gene associations with the susceptibility of Kawasaki disease and coronary artery lesions. PLoS One 2015;10:e0143056. https://doi.org/10.1371/journal.pone.0143056