INCREASED SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH-FACTOR IN KAWASAKI-DISEASE

Vascular endothelial growth factor (VEGF) is an angiogenic mitogen tha t specifically targets vascular endothelial cells. The objective of th is study was to evaluate the role of VEGF in Kawasaki disease (KD), th e most common cause of systemic vasculitis in childhood. Serum VEGF le vels were measured by ELISA in 22 patients with KD, 22 febrile childre n with infection, and 19 healthy children. Samples from KD patients we re divided into three groups: acute stage (n = 20), subacute stage (n = 13), and convalescent stage (n = 15). The results showed that KD pat ients in the acute and subacute stages had significantly higher levels of VEGF than did patients with infectious diseases and the healthy co ntrol subjects. When compared with the VEGF levels of patients with an d without coronary artery lesions (CAL), significantly higher levels o f VEGF were observed in the subacute stage in patients with CAL and in patients without CAL in the acute stage. Serial examination revealed that the serum VEGF levels in KD patients with CAL increased from a re latively low level in the acute stage to an extremely high level in th e subacute stage. In contrast, patients without CAL were found to have extremely high levels of VEGF only in the acute stage of KD. In KD pa tients, the serum VEGF levels did not correlate with the inflammatory markers and clinical symptoms. Our results raise the possibility that VEGF is involved in the pathogenesis of KD, especially in the developm ent of GAL. Further study is needed to clarify the biologic effect of VEGF on coronary arteries in KD.