Soluble LR11 as a Novel Biomarker in Acute Kawasaki Disease

• Published in: Circulation Journal Vol. 86; no. 6; pp. 977 - 983
• Main Authors: Watanabe, Kenichi, Suzuki, Hiroshi, Jiang, Meizi, Tsukano, Shinya, Kataoka, Satoshi, Ito, Sueshi, Sakai, Takatsugu, Hirokawa, Toru, Haniu, Hisanori, Numano, Fujito, Hoshina, Satoshi, Hasegawa, Satoshi, Matsunaga, Masamichi, Chiba, Kousei, Saito, Naka, Yoshida, Hiroshi, Takami, Satoru, Okubo, Soichiro, Hirano, Harunobu, Saitoh, Akihiko, Bujo, Hideaki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.05.2022
• Subjects: Biomarkers; Humans; Immunoglobulins, Intravenous - therapeutic use; Intravenous immunoglobulins; Kawasaki disease; LDL-Receptor Related Proteins; LR11; Membrane Transport Proteins; Mucocutaneous Lymph Node Syndrome - diagnosis; Mucocutaneous Lymph Node Syndrome - drug therapy; Biomarkers; Kawasaki disease; Intravenous immunoglobulins; LR11
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-20-1271

Background: Intimal smooth muscle cells (SMCs) play an important role in the vasculitis caused by Kawasaki disease (KD). Lipoprotein receptor 11 (LR11) is a member of the low-density lipoprotein receptor family, which is expressed markedly in intimal vascular SMCs and secreted in a soluble form (sLR11). sLR11 has been recently identified as a potential vascular lesion biomarker. sLR11 is reportedly elevated in patients with coronary artery lesions long after KD, but there is no description of sLR11 in acute KD. Our aim was to determine the sLR11 dynamics in acute KD and to assess its usefulness as a biomarker.Methods and Results: 106 acute KD patients and 18 age-matched afebrile controls were enrolled. KD patients were classified into the following subgroups: intravenous immunoglobulin (IVIG) responders (n=85) and non-responders (n=21). Serum sLR11 levels before IVIG therapy were higher in non-responders (median, 19.6 ng/mL; interquartile range [IQR], 13.0–24.9 ng/mL) than in controls (11.9 ng/mL, 10.4–14.9 ng/mL, P<0.01) or responders (14.3 ng/mL, 11.7–16.5 ng/mL, P<0.01). Using a cutoff of >17.5 ng/mL, non-responders to initial IVIG therapy were identified with 66.7% sensitivity and 78.8% specificity.Conclusions: sLR11 can reflect the state of acute KD and might be a biomarker for patient response to IVIG therapy.