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Original article
Thrombospondin-2 predicts response to treatment with intravenous immunoglobulin in children with Kawasaki disease
  1. Shuai Yang1,
  2. Ruixia Song1,
  3. Xiaohui Li1,
  4. Ting Zhang2,
  5. Jin Fu3,
  6. Xiaodai Cui3
  1. 1 Department of Cardiovascular Diseases, Children’s Hospital Capital Institute of Pediatrics, Beijing, China
  2. 2 Central Laboratory of Infection and Immunity, Capital Institute of Pediatrics, Beijing, China
  3. 3 Clinical Center Laboratory, Capital Institute of Pediatrics, Beijing, China
  1. Correspondence to Dr Xiaohui Li; lxhmaggie{at}126.com

Abstract

Objective To investigate the predictive value of thrombospondin-2 (TSP-2) in assessing the response to intravenous immunoglobulin (IVIG) in children with acute Kawasaki disease (KD).

Methods This was a cohort study with controls. 71 children with KD were recruited as the case group, including IVIG non-responder (n=17) and IVIG responder (n=54), and healthy children (n=27) and febrile children (n=30) were used as control groups. ELISA was used to measure plasma TSP-2 and TSP-1 levels. The rank-sum test was used to compare groups of non-normally distributed data. Predictive value was evaluated through the receiver operating characteristic (ROC) curve.

Results Compared with the control groups, the plasma TSP-2 levels in acute KD were significantly elevated (TSP-2: 31.00 (24.02, 39.28) vs 21.93 (17.00, 24.73) vs 16.23 (14.00, 19.64) ng/mL, P<0.001). The plasma TSP-2 level in the IVIG non-responder was significantly higher than the responder group (37.58 (31.86, 43.98) vs 27.84 (21.88, 33.48) ng/mL, P=0.002). When using an ROC curve to analyse the predictive effect of TSP-2 on non-responsiveness to IVIG treatment, the area under the curve was 0.752 (0.630, 0.875) (P=0.002). When the cut-off value for TSP-2 was 31.50 ng/mL, the sensitivity was 82.35%, the specificity was 64.81%.

Conclusion The plasma TSP-2 level was elevated in acute KD and it might be a novel predictor for IVIG resistance, which could help guide clinicians to choose individualised initial therapeutic regimens.

  • Kawasaki disease
  • thrombospondin-2
  • thrombospondin-1
  • immunoglobulin non-response

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors XL obtained funding and designed the study. SY and RS were involved in data collection, verification, analysis and specimen detection. TZ, JF and XC took part in experimental guidance. RS drafted the manuscript and SY revised the paper. XL contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. All authors have read and approved the final manuscript. XL is the study guarantor.

  • Funding This work was supported by Research Project for the Application of Clinical Characteristics in Capital (Grant No. Z131107002213035) and Research Fund for Clinical Technology Innovation Project of Beijing Hospital Authority (Grant No. XMLX201612).

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Ethics approval The Ethics Committee of Children’s Hospital Capital Institute of Pediatrics (No. 2012026).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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