Research & Innovation
Research on Kawasaki disease
There’s still a lot to learn about Kawasaki disease. Ongoing research in Kawasaki disease at Children’s Hospital includes studies in several areas, such as:
- searching for genetic factors that may play a role in the susceptibility of Kawasaki disease
- finding a test to aid in the diagnosis of Kawasaki disease
- advances in treatment options for children who don’t respond to conventional therapy, delineating the long-term sequelae of Kawasaki disease in patients with and without coronary aneurysms
Genetic research in Kawasaki disease. Children’s investigators participate in a multi-center study aimed at increasing our understanding of why certain children become affected with Kawasaki disease. Experts believe that there may be genetic susceptibility in determining why some children get this illness. DNA is obtained from the child with Kawasaki disease and ideally from both biological parents.
Developing a diagnostic test for Kawasaki disease. By analyzing the urine of patients with Kawasaki disease, researchers are working to identify the “biomarkers”—the molecular telltale signs—that can serve as diagnostic and prognostic indicators for the condition. A quicker diagnosis of Kawasaki disease could lead to more efficient treatment, with the potential for fewer complications and less discomfort.
Our Proteomics Center has excelled in developing fast, efficient and minimally invasive diagnostics by studying biomarkers for disease that are found in urine. Urine is easier to obtain than blood and has a narrower range of molecules and proteins to study. Recent innovations that diagnose appendicitis early by finding these urinary biomarkers have encouraged the current study to find biomarkers for Kawasaki disease, which is funded by a one-year grant from Children’s Translational Research Program.
Alex Kentsis, MD, PhD, Hanno Steen, PhD, director of Children’s Proteomics Center, and Susan Kim, MD, MMSc, rheumatologist and the clinical investigator enrolling patients for the study, will continue to build the molecular profile for Kawasaki disease by studying the urine of children with the condition, before and after treatment. They’ll compare these samples to urine samples from children with symptoms similar to Kawasaki disease, but stemming from a known, separate condition.
Finding these markers may also help researchers characterize the pathophysiology of Kawasaki disease, which is still unclear to scientists. “If certain proteins are elevated in the urine, we may be able to determine where those proteins originate from, and possibly develop more effective treatment,” says Kim.
Vascular health in Kawasaki disease. The study examines the long-term effects of Kawasaki Disease on vascular health by comparing test results of 200 patients who’ve had KD to the test results of 50 age- and gender-matched healthy controls. We use three non-invasive techniques to study vessel reactivity: EndoPAT, carotid ultrasound and Millar tonometry. Each of these techniques provides insight into the health of the patient’s blood vessels, evaluating the stiffness of the vessels in different parts of the body, and the blood vessel reactivity.
In addition to these tests, we gain information about the patient through questionnaires about exercise habits, eating habits, and personal and family medical history. Finally, we measure cholesterol levels and markers of inflammation in the blood. We hope to determine if there are long-term differences between those who’ve had Kawasaki disease and those who haven’t—and, if yes, what those differences are. We also hope to explore the factors that might lead to long-term effects based on the initial severity of the illness and the current condition of the coronary arteries in each patient.
In addition to these studies, for which patients with a history of Kawasaki disease are currently being recruited, Children’s investigators also participate in a number of studies analyzing the database of existing patients with Kawasaki disease (e.g., “retrospective” studies). Children’s is a member of the Pediatric Heart Network (PHN), a group of researchers who’ve combined their efforts to study Kawasaki disease, among other heart conditions in young people.
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