Table 4_Alterations in bile acid metabolites associated with pathogenicity and IVIG resistance in Kawasaki disease.docx

BackgroundKawasaki disease (KD) primarily affects children as an acute systemic vasculitis. Numerous studies indicated an elevated risk of cardiovascular disease due to metabolic disturbances. Despite this knowledge, the specific metabolic modes involved in KD remain unclear.
MethodsWe examined the metabolome of individuals with 108 KD and 52 non-KD controls (KD vs. nKD) by ultraperformance liquid chromatography (UPLC) and tandem mass spectrometry (MS).
ResultsDifferential analysis uncovered the disturbed production of bile acids and lipids in KD. Furthermore, we investigated the impact of treatment, intravenous immunoglobulin (IVIG) resistance, and coronary artery (CA) occurrence on the metabolome. Our findings suggested that IVIG treatment alters the lipid and amino acid metabolism of KD patients. By orthogonal projections to latent structures discriminant analysis (OPLS-DA), there was no significant difference between the coronary injury groups and non-coronary injury groups, and IVIG resistance didn't appear to cause the metabolic change in KD patients.
ConclusionsPatients with KD exhibit metabolic abnormalities, particularly in bile acids and lipids. IVIG interventions may partially ameliorate these lipid abnormalities.

研究背景：川崎病（Kawasaki disease, KD）是一种主要累及儿童的急性全身性血管炎。多项研究表明，代谢紊乱会增加心血管疾病的发病风险。尽管已有此类认知，但川崎病发病相关的特异性代谢模式仍未明确。
研究方法：本研究采用超高效液相色谱（ultraperformance liquid chromatography, UPLC）结合串联质谱（tandem mass spectrometry, MS）技术，对108名川崎病患者及52名非川崎病对照个体（KD组vs. nKD组）的代谢组进行检测分析。
研究结果：差异分析显示，川崎病患者体内胆汁酸与脂质的生成存在紊乱。此外，本研究探讨了治疗干预、静脉注射免疫球蛋白（intravenous immunoglobulin, IVIG）耐药以及冠状动脉（coronary artery, CA）受累对代谢组的影响。结果表明，IVIG治疗可改变川崎病患者的脂质与氨基酸代谢模式。通过正交偏最小二乘判别分析（orthogonal projections to latent structures discriminant analysis, OPLS-DA）发现，冠状动脉损伤组与非损伤组的代谢组无显著差异，且IVIG耐药似乎并未引发川崎病患者的代谢改变。
研究结论：川崎病患者存在代谢异常，尤以胆汁酸与脂质代谢紊乱为显著特征；IVIG干预可部分改善此类脂质代谢异常。