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Japanese journal of infectious diseases. 09/2012; 65(5):455-7.
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ABSTRACT: BACKGROUND/PURPOSE: Acute otitis media (AOM) is a common complication of upper respiratory tract infection (URTI) among children. The purpose of this study was to evaluate the epidemiology of AOM among young children in Taiwan, including the age incidence and seasonality by combining multiple databases. METHODS: Two country-based questionnaire survey studies had been conducted to evaluate the experience of otitis media (OM) among young children: one in 2007 and the other between 2005 and 2010. The number of OM cases (5% of population younger than 7 years) in 2005 and annual visiting rates for URTI from 2005 to 2010 obtained from the National Health Insurance Research Database of Taiwan were collected and comprised the third database. The fourth database comprised ambulatory visits of children with OM to a medical center in central Taiwan between 2005 and 2010. RESULTS: Data from a total of 1099 questionnaires were entered into Database I in 2007, and data from 9705 questionnaires between 2005 and 2010 comprised Database II. There were 86,702 children (younger than 7 years, representing 5% of the whole population for this age group) retrieved from Database III in 2007, and 5,904 cases of OM in children between 2005 and 2010 in a hospital. In Database I, 7.46% children experienced at least one episode of AOM compared with 9.21% in Database II for children aged 5 years and younger. In Database III, 13.2% children younger than 7 years had AOM in 2005. The peak season of AOM among children was from March to May (Databases III and IV). CONCLUSION: AOM was thought to be a very common disease among children; however, this comparative analysis showed that the overall prevalence of AOM among children younger than 5 years was only 20%, much lower than in other countries. AOM was more prevalent during the spring season, and still was similarly common after age 2 years.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 07/2012; · 0.99 Impact Factor
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Kao-Pin Hwang,
Fang-Tzy Wu,
Krisztián Bányai,
Ho-Sheng Wu,
Dustin Chen-Fu Yang,
Yhu-Chering Huang,
Jen-Shiou Lin,
Chao Agnes Hsiung,
Jason C Huang,
Baoming Jiang,
Jon R Gentsch
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ABSTRACT: The molecular characterization of genotype P[6] rotavirus strains collected from children admitted to hospital with acute dehydrating diarrhoea during a 6-year surveillance period in Taiwan is described in this study. In total, three G4P[6] strains, one G5P[6] and one G12P[6] were characterized by sequencing and phylogenetic analysis of the VP4, VP7, VP6 and NSP4 genes. Whilst all four genes of the single Taiwanese G12P[6] strain clustered with the respective genes of globally common human rotavirus strains, the G4 and G5 strains showed remarkable similarities to porcine rotavirus strains and putative porcine-origin human P[19] strains reported previously from Taiwan. The overall proportion of porcine rotavirus-like strains in Taiwan remains around 1 % among hospitalized children; however, the circulation and sporadic transmission of these heterotypic strains from pigs to humans could pose a public-health concern. Therefore, continuation of strain monitoring is needed in the vaccine era to detect any possible vaccine breakthrough events associated with the introduction of such heterologous rotavirus strains.
Journal of Medical Microbiology 03/2012; 61(Pt 7):990-7. · 2.50 Impact Factor
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Yi-Ching Lee,
Ho-Chang Kuo,
Jeng-Sheng Chang,
Luan-Yin Chang,
Li-Min Huang,
Ming-Ren Chen,
Chi-Di Liang,
Hsin Chi,
Fu-Yuan Huang,
Meng-Luen Lee, [......],
Nan-Chang Chiu, Kao-Pin Hwang,
Pi-Chang Lee,
Li-Ching Chang,
Yi-Min Liu,
Ying-Ju Chen,
Chien-Hsiun Chen,
Yuan-Tsong Chen,
Fuu-Jen Tsai,
Jer-Yuarn Wu
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ABSTRACT: To find new candidate loci predisposing individuals to Kawasaki disease, an acute vasculitis that affects children, we conducted a genome-wide association study in 622 individuals with Kawasaki disease (cases) and 1,107 controls in a Han Chinese population residing in Taiwan, with replication in an independent Han Chinese sample of 261 cases and 550 controls. We report two new loci, one at BLK (encoding B-lymphoid tyrosine kinase) and one at CD40, that are associated with Kawasaki disease at genome-wide significance (P < 5 × 10(-8)). Our findings may lead to a better understanding of the role of immune activation and inflammation in Kawasaki disease pathogenesis.
Nature Genetics 03/2012; 44(5):522-5. · 35.53 Impact Factor
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ABSTRACT: Rotavirus G3P[3] strains have been reported from a variety of species including humans, cats, dogs, monkeys, goats, and cows. Here, we report the characterization of the first human G3P[3] rotavirus from East Asia identified in a 2-year-old child who was treated in a hospital's emergency ward in Taiwan in February 2005. Sequence and phylogenetic analysis demonstrated a close genetic relationship between the VP4, VP6, VP7, and NSP4 genes of Taiwanese G3P[3] strain 04-94s51 and an Italian canine strain isolated a decade ago, suggesting a canine origin for the Taiwanese strain. In contrast, the Taiwanese strain was only moderately related to well-characterized canine-origin human G3P[3] strains Ro1845 and HCR3, suggesting a distinct origin for the rotavirus strain from Taiwan.
Vector borne and zoonotic diseases (Larchmont, N.Y.) 02/2012; 12(2):170-3. · 2.61 Impact Factor
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ABSTRACT: Acute gastroenteritis is a common illness in children under 5 years old. Although rotavirus is a leading cause, other viruses including astrovirus are also important, but have been the subject of limited studies. This is a prospective study to investigate astrovirus gastroenteritis in hospitalized children in Taiwan.
From January 2009 to December 2009, children below 5 years of age admitted to three hospitals in Taiwan due to acute gastroenteritis were eligible for this study. Stool specimens were sent for the detection of astrovirus by reverse transcriptase polymerase chain reaction; once positive for astrovirus, the sequencing and phylogenetic analysis of each strain was performed.
A total of 989 children were enrolled during the study period. The overall positive rate of astrovirus was 1.6%, ranging from 1.03% to 2.26% in different hospitals, while rotavirus accounted for 20.2% of the patients. Six of the 16 children (37.5%) with astroviral infection had documented coinfection with rotavirus. The median age of infection was 28.2 months. The seasonal distribution of astrovirus peaked from April to June. Diarrhea alone (40% vs. 2.1%, p < 0.0001) was significantly more commonly seen than the triad of fever, vomiting and diarrhea (30% vs. 71%, p = 0.0062) in children with astroviral infection alone than in those with rotaviral infection alone. The mean duration of diarrhea was significantly longer in patients with mixed infection than those with astroviral infection alone (6.8 vs. 4.2 days, p = 0.013). Respiratory symptoms were noted in 10 children (62.5%). Serotype HAstV-1 was the most common (68.8%).
Astrovirus accounted for 1.6% of infections in children under 5 years hospitalized with acute gastroenteritis in Taiwan. Compared with those caused by rotavirus, the incidence of gastroenteritis in hospitalized children caused by astrovirus was low and the disease severity was mild.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 12/2011; 45(4):311-7. · 0.99 Impact Factor
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Fang-Tzy Wu,
Krisztián Bányai,
Jason C Huang,
Ho-Sheng Wu,
Feng-Yee Chang,
Jyh-Yuan Yang,
Chao Agnes Hsiung,
Yhu-Chering Huang,
Jen-Shiou Lin, Kao-Pin Hwang,
Baoming Jiang,
Jon R Gentsch
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ABSTRACT: We previously reported the detection of genotype P[19] rotavirus strains from children hospitalized with acute dehydrating diarrhea during a 5-year surveillance period in Taiwan. The characterization of five P[19] strains (0.4% of all typed), including three G3P[19], a novel G5P[19], and a unique G9P[19] genotype is described in this study. Phylogenetic analysis of the VP4, VP7, VP6, and NSP4 genes was performed, which demonstrated novel lineages for respective genotypes of the VP4 and the VP7 genes. The sequence similarities of the P[19] VP4 gene among Taiwanese human strains was higher (nt, 91.5-96.2%; aa, 93.7-97.6%) than to other P[19] strains (nt, 83.5-86.6%; aa, 89.4-94.1%) from different regions of the world. The VP7 gene of the three G3P[19] Taiwanese strains shared up to 93.4% nt and 97.5% aa identity to each other but had lower similarity to reference strain sequences available in GenBank (nt, <90.1%; aa, <95.6%). Similarly, the VP7 gene of the novel G5P[19] strain was only moderately related to the VP7 gene of reference G5 strains (nt, 82.2-87.3%; aa, 87.0-93.1%), while the VP7 gene of the single G9P[19] strain was genetically distinct from other known human and animal G9 rotavirus strains (nt, ≤ 92.0%; aa, ≤ 95.7%). Together, these findings suggest that the Taiwanese P[19] strains originated by independent interspecies transmission events. Synchronized surveillance of human and animal rotaviruses in Taiwan should identify possible hosts of these uncommon human rotavirus strains.
Journal of Medical Virology 07/2011; 83(7):1279-87. · 2.82 Impact Factor
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ABSTRACT: The heptavalent pneumococcal conjugate vaccine was introduced in Taiwan in October 2005. To evaluate the effect of the vaccination, we conducted an active, prospective, large-scale, long-term, and multicenter study to assess the prevalence of nasopharyngeal Streptococcus pneumoniae carriage in Taiwanese children.
This study was performed at three tertiary teaching hospitals in northern, central, and southern Taiwan. Questionnaires provided demographic, family/household, and medical history data. Pneumococcal isolates were tested for their susceptibility to various antimicrobial agents and serotypes. In addition, influenza virus and Staphylococcus aureus were recovered from nasopharyngeal and nasal swabs, respectively.
Between July 2005 and July 2008, 857 pneumococcal strains were recovered from a total of 6057 children aged >2 months to 5 years (carriage rate, 14.1%). Carriage rates differed geographically and varied with subject age. In a multivariate analysis, having at least one sibling, attendance at day-care centers, a history of otitis media, and history of upper respiratory tract infection in the previous 2 weeks were each associated with a higher risk of pneumococcal colonization of the nasopharynx. Staphylococcus aureus nasal colonization was inversely associated with nasopharyngeal carriage of pneumococcus (p=0.000; odds ratio [OR]: 0.48; 95% CI: 0.39-0.58). Daycare attendance was the only risk factor for carriage of penicillin non-susceptible S. pneumoniae (OR: 2.37; 95% CI: 1.22-4.88). Although vaccination rates rose from 2005 to 2008, no concomitant decrease in S. pneumoniae carriage occurred. The rate of penicillin resistance among S. pneumoniae isolates was 92.8% (using the meningitis criteria). The prevalence of cefotaxime resistance (21.6%) was higher than that of penicillin (6.9%; non-meningitis criteria). Slightly more than half (57.4%) of the isolates belonged to strains covered by the heptavalent pneumococcal conjugate vaccine when both vaccine and vaccine-related serotypes were included.
Although vaccination rates rose from 2005 to 2008, no concomitant decrease occurred in S. pneumoniae carriage. Interaction between S. aureus and S. pneumoniae may influence vaccination efficacy. These findings provide baseline data to further compare pneumococcal carriage rates and antibiotic resistance patterns in Taiwanese children as vaccination rates continue to increase.
Vaccine 05/2011; 29(32):5171-7. · 3.77 Impact Factor
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ABSTRACT: The species of Capnocytophaga and Aggregatibacter are normal flora and mostly cause periodontal diseases. The soft tissue infection caused by Aggregatibacter often is associated with Actinomyces species. Beside, most Capnocytophaga infections are described in immunocompromised patients. We identified facial cellulitis caused by Capnocytophaga spp and Aggregatibacter (Actinobacillus) actinomycetemcomitans in a 16-year-old immunocompetent female.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 04/2011; 44(2):149-51. · 0.99 Impact Factor
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ABSTRACT: Acute diarrhea is one of the most common morbidities in pediatrics worldwide. We conducted a study to investigate the incidence of norovirus in young children hospitalized with acute diarrhea in Taiwan and its clinical peculiarity compared with rotavirus gastroenteritis.
Between January and December, 2009, patients younger than 5 years and admitted to hospital with acute diarrhea were randomly selected; and their stool samples were collected and tested for presence of rotavirus and norovirus by enzyme immunoassay and reverse transcription-polymerase chain reaction, respectively. The clinical manifestations and laboratory findings of the enrolled patients were analyzed.
A total of 989 cases were enrolled with a mean age of 21.6 ± 13.7 months and a male proportion of 56.0%. Rotavirus and norovirus was detected in 20.2% and 14.6% of all patients, respectively. Genogroup II was the predominant strain of norovirus (80.6%). Children aged 6-36 months accounted for the majority of patients positive for rotavirus and norovirus (73.0% and 81.3%, respectively). The incidences of norovirus and rotavirus infection were higher during winter and early spring. Most patients with rotavirus and norovirus diarrhea experienced vomiting (74.9%vs. 74.8%, respectively) and fever (94.7%vs. 71.3%, respectively).
Most young diarrheal patients presenting with vomiting were likely to have norovirus or rotavirus infection. Patients with norovirus diarrhea experienced an absence of, or low-grade fever and longer duration of vomiting compared with those positive for rotavirus infection. A family history of current gastroenteritis may suggest the possibility of norovirus infection.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 12/2010; 43(6):506-14. · 0.99 Impact Factor
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ABSTRACT: Methicillin-resistant Staphylococcus aureus (MRSA) has been identified as a major cause of community-associated (CA) S. aureus infections in the past decade. The main reservoir in the community for MRSA and the factors contributing to its worldwide spread remain poorly defined. Between July 2005 and June 2008, a total of 6,057 healthy children 2 to 60 months of age were screened for carriage of S. aureus and Streptococcus pneumoniae in Taiwan. The prevalence and epidemiological factors influencing MRSA carriage were determined. MRSA strains were tested for antimicrobial susceptibility and underwent molecular characterization. The overall prevalences of MRSA and S. aureus carriage were 7.8% and 23.2%, respectively. A majority (88%) of MRSA isolates belonged to a common Asian-Pacific CA-MRSA lineage, multilocus sequence type 59, and were resistant to multiple non-beta-lactam antibiotics. The carriage rate of MRSA was higher among subjects 2 to 6 months old (P < 0.0001), residing in northern Taiwan (P = 0.0003), and enrolled later in the study (P < 0.0001). MRSA colonization was associated with the number of children in the family (adjusted odds ratio [aOR], 1.114; 95% confidence interval [CI], 1.002 to 1.240; P = 0.0463) and day care attendance (aOR, 1.530; 95% CI, 1.201 to 1.949; P = 0.0006). Breast feeding (P < 0.0001) and colonization with S. pneumoniae (P = 0.0170) were protective against MRSA colonization. We concluded that epidemic CA-MRSA strains increasingly colonized Taiwanese children between 2005 and 2008. The carriage rate varied significantly across different demographical features. Crowding was an independent environmental risk factor that might accelerate CA-MRSA transmission in the community.
Journal of clinical microbiology 11/2010; 49(1):131-7. · 4.16 Impact Factor
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ABSTRACT: Kawasaki disease (KD) is the leading cause of acquired heart disease during childhood in the developed countries. Coronary artery lesions (CAL) are the major complications of KD. A unique proteomic profiling with increased or decreased fibrinogen, alpha-1-antitrypsin, clusterin, and immunoglobulin free light chains were noted in KD in our previous study. The purpose of this study was to evaluate relations between these biomarkers and CAL in KD and to establish within the markers the appropriate cut-off value with which to predict the occurrence of CAL. A total of 47 KD patients were enrolled, including 14 with CAL and 33 without CAL. Plasma samples from patients with KD before intravenous immunoglobulin administration were indicated for measurement of these biomarkers. A potential relation among CAL, clinical characteristics, and these biomarkers was investigated, and a receiver operating characteristic curve was used to identify a cut-off value of the significant marker that best predicated the occurrence of CAL. Among these biomarkers, only plasma clusterin level was associated with the occurrence of CAL. Using a cut-off value of clusterin <12.0 mg/l, the relative risk for CAL was 4.53-fold (95% confidence interval [CI] 1.060-19.347%, P = 0.014). Results from this study suggest that plasma clusterin level <12.0 mg/l in KD is significantly associated with the occurrence of CAL. Results from this study provide a potential biomarker of KD that may help predict the occurrence of CAL.
Pediatric Cardiology 11/2010; 31(8):1151-6. · 1.30 Impact Factor
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ABSTRACT: Kawasaki disease (KD) is a systemic vasculitis primarily affecting children who are <5 years old. Intravenous immunoglobulin (IVIG) is the standard therapy for KD. However, many patients with KD still show poor response to initial IVIG treatment. This study was conducted to investigate the risk factors for initial IVIG treatment failure in KD.
Children who met KD diagnosis criteria and were admitted for IVIG treatment were retrospectively enrolled for analysis. Patients were divided into IVIG-responsive and IVIG-resistant groups. Initial laboratory data before IVIG treatment were collected for analysis.
A total of 131 patients were enrolled during the study period. At 48 h after completion of initial IVIG treatment, 20 patients (15.3%) had an elevated body temperature. Univariate analysis showed that patients who had initial findings of high neutrophil count, abnormal liver function, low serum albumin level (≤2.9 g/dL) and pericardial effusion were at risk for IVIG treatment failure. Multivariate analysis with a logistic regression procedure showed that serum albumin level was considered the independent predicting factor of IVIG resistance in patients with KD (p = 0.006, OR = 40, 95% CI: 52.8-562). There was no significant correlation between age, gender, fever duration before IVIG treatment, haemoglobin level, total leucocyte and platelet counts, C-reactive protein level, or sterile pyuria and initial IVIG treatment failure. The specificity and sensitivity for prediction of IVIG treatment failure in this study were 96% and 34%, respectively.
Pre-IVIG treatment serum albumin levels are a useful predictor of IVIG resistance in patients with KD.
Acta Paediatrica 10/2010; 99(10):1578-83. · 2.07 Impact Factor
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Pediatrics International 08/2010; 52(4):e221-3. · 0.63 Impact Factor
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ABSTRACT: Infections caused by extended-spectrum β-lactamase (ESBL)-producing bacteria have become a serious clinical concern worldwide. The occurrence of ESBLs in Taiwan has been well-documented and is reviewed in recent publications. However, studies comparing community-onset bacteremia caused by ESBL- and non-ESBL-producing Escherichia coli are limited.
We retrospectively reviewed the medical records of patients with E. coli bacteremia who visited the emergency department of Kaohsiung Chang Gung Memorial Hospital from January 2005 to December 2006. Clinical data were collected to compare the clinical features of patients with ESBL-producing E. coli with those of patients with non-ESBL-producers and to identify the risk factors associated with ESBL-producing E. coli bacteremia.
There were 404 episodes of community-onset E. coli bacteremia. The overall 30-day mortality rate was 11.4% (46/404) and the mortality rate of healthcare-associated infections was significantly higher than that of community-acquired infections [4/13 (30.8%) vs. 42/391 (10.7%); p= 0.049] Nonurinary focus was independently associated with an increased risk of fatality [47/178 (26.4%) vs. 4/226 (1.8%); p < 0.001]. The frequency of ESBL producers was 4.7% (19/404). Of these, four (21.1%) were associated with a long-term care facility. Significant risk factors associated with ESBL-producing E. coli bacteremia included recent antibiotic exposure (within 30 days) and urinary catheter placement. Although the trend was towards higher mortality in patients with ESBL-producing E. coli bacteremia, the difference did not reach statistical significance compared with the mortality of patients with non-ESBL E. coli bacteremia.
Fewer than 5% of community-onset E. coli bacteremia episodes in Southern Taiwan were due to ESBL-producers. Prior antibiotic use within 30 days and urinary catheter placement were independently associated with ESBL-producing E. coli bacteremia.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 06/2010; 43(3):240-8. · 0.99 Impact Factor
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ABSTRACT: Aspartic proteases are a family of proteinases with catalytic aspartate residues in the active site. These enzymes have been reported to initialize the degradation of host hemoglobin in blood-feeding helminths. After identifying an expressed sequence tag representing an aspartic protease from an Angiostrongylus cantonensis young adult dataset, this sequence was found to encode a protein with a predicted molecular mass of 46 kDa. It also showed good homologies to aspartic proteases from Caenorhabditis elegans (50.7% identity), Haemonchus contortus (43.0% identity), Necator americanus (41.5% identity), Strongyloides stercoralis (35.9% identity), and Burgia malayi (29.6% identity). This putative aspartic protease was determined to be expressed in the infective larvae, young adults, and adult worms of A. cantonensis by quantitative real-time PCR. Among male worms, the expression level was determined to increase by 223.0 + or - 24.2 fold in young adults relative to the infective larvae and then decreased to 7.1 + or - 0.2 fold in adult worms. In female worms, the expression level was observed to increase by 118.5 + or - 10.1 fold in young adults and by 277.5 + or - 29.2 fold in the adults, when compared with infective larvae. These findings not only indicate that the expression level of aspartic protease gene in A. cantonensis changes with development but also has a sexual difference in individual developmental stages in the final host.
Acta tropica 11/2009; 113(3):289-94. · 2.22 Impact Factor
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ABSTRACT: To compare the antimicrobial activities of ertapenem, ciprofloxacin, ceftriaxone, piperacillin-tazobactam, and ampicillin-sulbactam against 12 common organisms that cause community-acquired bacteremia and to identify the most active agents for the treatment of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae.
1200 blood specimens from patients with community-acquired bacteremia were collected at Chang Gung Memorial Hospital, Kaohsiung, Taiwan. All isolates were identified by the API system, and each culture's antimicrobial susceptibility was determined by the standard disk-diffusion method. The minimal inhibitory concentrations of the antibiotics were detected by the Epsilimeter test.
The in vitro susceptibilities of 11 of the 12 common pathogens to ertapenem were 100%. The frequency of ESBL-producing E. coli and K. pneumoniae was 6.2% and 9.5%, respectively. Only 48% and 50% of E. coli and K. pneumoniae, respectively, were susceptible to ciprofloxacin. These data infer that ciprofloxacin should not be given for ESBL-producing E. coli and K. pneumoniae. Ceftriaxone and piperacillin-tazobactam had high activity against the most common pathogens isolated.
ESBL E. coli and K. pneumoniae are highly resistant to ciprofloxacin, so this antibiotic should be avoided for patients with community-acquired bacteremia. ESBL E. coli and K. pneumoniae are highly susceptible to ertapenem.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 10/2009; 42(5):433-8. · 0.99 Impact Factor
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ABSTRACT: This study aimed to examine whether spatial-temporal patterns of dengue can be used to identify areas at risk of dengue hemorrhagic fever (DHF).
Three indices - probability of case-occurrence, mean duration per wave, and transmission intensity - were used to differentiate eight local spatial-temporal patterns of dengue during the 2002 epidemic in Kaohsiung, Taiwan. DHF densities (DHF cases/km(2) per 100 dengue cases) in each spatial-temporal typed area were compared.
Areas with three high indices correlated with the highest DHF density: (1) high transmission intensity only; (2) long duration of wave only, and (3) high transmission intensity plus long duration of wave. However, cumulative incidences of dengue cases were not correlated with DHF densities.
Three spatial-temporal indices of dengue could provide useful information to identify areas at high risk of DHF.
International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 09/2009; 14(4):e334-43. · 2.17 Impact Factor
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ABSTRACT: Congenital tracheal stenosis is a rare airway disorder characterized by a fixed tracheal narrowing. Surgical intervention is usually considered as the treatment of choice for long-segment type. However, due to wide spectrum of this disease, treatment modalities need to be individualized. The long-segment type has the most unfavorable outcome because it is often associated with multiple anomalies and, thus, the most difficult to manage. Here we present a case of long-segment congenital tracheal stenosis (LSCTS) that was managed by several sessions of flexible bronchoscopic balloon tracheoplasty as the primary treatment. In this particular situation, we had to deal with the parents' request of a 'non-surgical' approach for an infant who had respiratory distress that also required a way to increase his tracheal diameter simultaneously. Having done this particular experience, we would like to show that this non-surgical approach can be viable for long-segment tracheal stenosis in selected cases.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 06/2009; 36(1):219-21. · 2.40 Impact Factor
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ABSTRACT: Kawasaki disease (KD) is a systemic febrile vasculitis particular coronary artery involvement. Eosinophilia has been found in our and other studies in KD. This study further investigates whether eosinophil-related T helper 2 (Th2) cytokines or the activation marker (eosinophil cationic protein - ECP) is involved in KD with coronary artery lesions (CAL). A total of 95 KD patients were enrolled for this study. Plasma samples were subjected to the measurement of interleukin (IL)-4, IL-5, and eotaxin by Luminex-Bedalyte multiplex beadmates system and to the measurement of ECP by fluoroimmunoassay. Patients with KD had higher eosinophils than controls. Eosinophil-related mediators: IL-4, IL-5, eotaxin, and ECP levels were also higher in KD patients than controls before intravenous immunoglobulin (IVIG) treatment. After IVIG treatment, ECP decreased but IL-4, IL-5, and eotaxin increased significantly. The higher the IL-5 and eosinophil levels after IVIG treatment, the lower rate of CAL was found. Changes of eosinophils after IVIG treatment were positively correlated to changes of IL-5 levels but not ECP levels. An increase of eosinophils and IL-5, but not ECP levels after IVIG treatment, was inversely correlated with CAL formation in KD.
Pediatric Allergy and Immunology 06/2009; 20(3):266-72. · 2.46 Impact Factor
