背景:Tenascin-C(TN-C)是与组织炎症相关的细胞外基质糖蛋白。我们先前在2016年进行的回顾性研究显示,对静脉免疫球蛋白(IVIG)耐药并发生冠状动脉病变(CAL)的川崎病(KD)患者的血清生腱蛋白-C水平较高。本研究是一项前瞻性队列研究,旨在评估生腱蛋白C的血清水平是否可以用作新的生物标志物来预测高危患者对初始治疗的抵抗风险。
方法:对380名KD患者进行登记,并在开始初始治疗前提供血清样本进行生腱蛋白-C测量。不符合纳入标准的患者被排除在分析之外;在剩下的181名受试者中,低危患者144例(小林评分:≤4分),高危患者37例(小林评分:≥5分).低危患者和高危患者的初始治疗为常规治疗(IVIG联合阿司匹林)和泼尼松龙联合治疗,分别。患者的临床和实验室数据,包括血清生腱蛋白-C水平,在初始治疗应答者和非应答者之间进行比较。
结果:在低风险患者中,初始治疗应答者和非应答者的血清生腱蛋白-C中位数水平无显著差异.然而,在高危患者中,初始治疗无反应者的中位血清生腱蛋白-C水平显著高于初始治疗有反应者(175.8ng/mlvs117.6ng/ml).
结论:血清生腱蛋白-C可能是预测高危患者对类固醇联合治疗无反应的风险的生物标志物。
背景:本研究为前瞻性队列研究。它由每个研究所的伦理委员会批准,并根据赫尔辛基宣言进行。
BACKGROUND: Tenascin-C (TN-C) is an extracellular matrix glycoprotein related to tissue inflammation. Our previous retrospective
study conducted in 2016 revealed that the serum tenascin-C level was higher in patients with Kawasaki disease (KD) who were resistant to intravenous immunoglobulin (IVIG) and developed coronary artery lesions (CALs). The present
study is a prospective cohort
study to assess if the serum level of tenascin-C could be used as a novel biomarker to predict the risk of resistance to initial treatment for high-risk patients.
METHODS: A total of 380 KD patients were registered and provided serum samples for tenascin-C measurement before commencing their initial treatment. Patients who did not meet the inclusion criteria were excluded from analysis; of the 181 remaining subjects, there were 144 low-risk patients (Kobayashi score: ≤4 points) and 37 high-risk patients (Kobayashi score: ≥5 points). The initial treatments for low-risk patients and high-risk patients were conventional therapy (IVIG with aspirin) and prednisolone combination therapy, respectively. The patient clinical and laboratory data, including the serum tenascin-C level, were compared between initial treatment responders and non-responders.
RESULTS: In the low-risk patients, there was no significant difference in the median levels of serum tenascin-C between the initial therapy responders and non-responders. However, in the high-risk patients, the median serum tenascin-C level in initial therapy non-responders was significantly higher than that in initial therapy responders (175.8 ng/ml vs 117.6 ng/ml).
CONCLUSIONS: Serum tenascin-C could be a biomarker for predicting the risk of high-risk patients being non-responsive to steroid combination therapy.
BACKGROUND: This
study was a prospective cohort
study. It was approved by the ethics committee of each institute and performed in accordance with the Declaration of Helsinki.