Platelet Vascular Endothelial Growth Factor Level Is Strongly Correlated with Coronary Artery Abnormalities in Kawasaki Syndrome

  • Kentaro Ueno, Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
  • Yuichi Nomura, Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
  • Kiminori Masuda, Department of Pediatrics, Kagoshima Medical Association Hospital, Japan
  • Yasuko Morita, Department of Pediatrics, Kagoshima Medical Association Hospital, Japan
  • Taisuke Eguchi, Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
  • Teruto Hashiguchi, Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
  • Ikuro Maruyama, Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
  • Yoshifumi Kawano, Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Japan

    • Objective: Vascular endothelial growth factor (VEGF) is an endothelial cell specific mitogen that induces major angiogenesis and microvascular permeability. Since activated platelets abundantly release VEGF in the early stage of vascular inflammation, we evaluated the clinical relevance of VEGF from a single platelet (platelet VEGF) and ascertain any correlation with coronary artery abnormalities (CAA) in Kawasaki syndrome (KS).
    Methods: Clinical features and results of blood examinations before IVIG treatment were compared 80 KS patients (69 IVIG responders, 11 IVIG non-responders) and 26 febrile patients with infections. We evaluated serum VEGF corrected using hematocrit and platelet counts.
    Results: KS patients had significantly higher levels of platelet VEGF (×10-8 pg) (18.8±11.1) than did patients with infectious diseases (8.1±3.0) (p<0.0001), although there was no significant difference in WBC or CRP. Platelet VEGF were higher in non-responders (25.2±17.6) than those in responders (17.8±8.1) but this difference was not statistically significant. Platelet VEGF was significantly higher in patients who showed higher maximum CAA z-score (> 3) (27.5±13.6) than in those who showed lower z-score (< 3) (16.1±6.9) (p<0.0001), while there were no significant differences in serum VEGF levels (983.5±601.8, and 902.9±347.8, respectively, p=0.29). Platelet VEGF was significantly correlated with z-score (R=0.524, p<0.0001), while serum VEGF level was not (R=0.21).
    Conclusions: Platelet VEGF level before IVIG treatment was strongly correlated with z-score and might be a useful predictor for CAA in KS patients.