Interleukin-18 and coronary artery lesions in patients with Kawasaki disease

Background: Interleukin-18 (IL-18) plays an important role in mediating cytokine cascade leading to coronary artery lesions (CALs) in Kawasaki disease (KM. However, our research suggested that the literature regarding IL-18 and KID is limited. Consequently, this study aimed to evaluate the correlation between IL-18 and CALs in patients with KD. Methods: In this prospective study of 14 children with KD (seven without and seven with CALs in the acute phase), we obtained patient measurements of a series of serum IL-18 levels in the acute, subacute, and convalescent phases. Serum IL-18 levels were measured with a Bio-Plex cytokine assay. Control samples were obtained from 18 febrile children with viral infection. Results: Compared with febrile controls, patients with acute-stage CALs [postintravenous immunoglobulin (post-IVIG) period] had a significantly higher IL-18 level (88.4 +/- 20.7 vs 56.0 +/- 35.0 pg/mL, p = 0.006). However, those without acute-stage CALs (post-WIG period) lacked similarly elevated IL-18 level readings (62.0 +/- 40.6 vs 56.0 +/- 35.0 pg/mL, p = 0.762). The IL-18 level of patients with acute-stage CALs did not decrease significantly until the convalescent phase (97.4 +/- 55.8 vs 38.7 +/- 22.6 pg/mL, p = 0.018), but for those without CALs, it decreased significantly in the subacute phase (60.2 +/- 37.4 vs 23.6 +/- 13.8 pg/mL, p = 0.018). In the subacute stage, there was a significant difference of IL-18 level between patients with and without acute-stage CALs (p = 0.048). Conclusion: Our data show that IL-18 levels were elevated in the acute phase of KD and might be related to the formation of CALs. Copyright (c) 2013 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.