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1.
J Pediatr ; 276: 114285, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39233116

RESUMEN

OBJECTIVE: To assess the role of prostaglandin E2 by measuring blood prostaglandin E2 metabolite (PGEM) concentrations in preterm infants with patent ductus arteriosus (PDA). STUDY DESIGN: A prospective observational study of preterm infants born before 32 weeks of gestational age (GA) was performed in a single tertiary hospital in Japan. Blood samples were collected to measure serum concentrations of PGEM, ibuprofen (IBU), and cytokines. Multiple regression analyses assessed associations between blood PGEM levels and perinatal factors, development of hemodynamically significant PDA (hsPDA), and IBU treatment response of hsPDA. RESULTS: Seventy-nine infants (median GA 28 weeks) were enrolled in this study. Forty-seven received IBU for hsPDA treatment 1 d after birth in median. PDA closure occurred in 25 infants after a single IBU treatment. Serum PGEM concentrations were associated with histologic chorioamnionitis (P < .01), but not with GA, respiratory distress syndrome, or serum IL-6 concentrations. Serum PGEM concentrations decreased after initial IBU treatment; however, they were not associated with hsPDA development (P = .39). IBU concentrations correlated with IBU treatment response (aOR 1.29, P < .01). However, pre-IBU serum PGEM levels and PGEM reduction ratio did not (P = .13, .15, respectively). CONCLUSIONS: Serum PGEM concentrations in preterm infants were associated with maternal histologic chorioamnionitis, but not hsPDA development. IBU treatment response was associated with higher blood IBU concentrations, but not PGEM concentrations.

2.
J Pediatr ; 152(6): 885-7, 887.e1, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18492537

RESUMEN

In this report, we describe a boy who showed mild symptoms of neonatal-onset multisystem inflammatory disease. Although his symptoms and laboratory findings were similar to those of systemic juvenile idiopathic arthritis, further examinations revealed papilledema, meningitis, and a NLRP3 mutation. His peripheral blood monocytes died within 24 hours after lipopolysaccharide stimulation, a test that may be useful for diagnosis even in mild cases.


Asunto(s)
Inflamación/diagnóstico , Lipopolisacáridos/farmacología , Monocitos/efectos de los fármacos , Muerte Celular , Niño , Humanos , Inflamación/sangre , Masculino , Índice de Severidad de la Enfermedad
3.
J Pediatr ; 151(2): 155-60, 160.e1, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17643768

RESUMEN

OBJECTIVE: To identify cytokine genes uniquely expressed in peripheral blood mononuclear cells (PBMNCs) in the acute phase of Kawasaki disease (KD) with coronary artery lesions (CALs). STUDY DESIGN: We screened the mRNA expression levels of PBMNCs from 4 pairs of KD patients with and without CAL using DNA microarray. The result was confirmed by real-time polymerase chain reaction (RT-PCR). The genetic association study was performed to analyze the significance of single nucleotide polymorphisms in the identified gene for the development of CAL in KD patients (184 controls, 144 KD patients with CAL, 64 KD patients without CAL). RESULTS: The microarray analysis showed that tissue inhibitor of metalloproteinases 2 (TIMP2) was expressed at higher levels in PBMNCs of KD patients with CAL than in KD patients without CAL. Quantitative RT-PCR confirmed that the expression levels were significantly higher in the KD patients with CAL than in those without CAL (P < .05). Among KD patients, TIMP2 promoter polymorphisms were significantly associated with a risk of CAL (P < .01). There was a significant difference in the transcriptional activities between the haplotypes of the TIMP2 promoter polymorphisms by reporter assay using U-937. CONCLUSIONS: TIMP2 overexpression and the promoter polymorphisms might play a role in the development of CALs.


Asunto(s)
Enfermedad Coronaria/genética , Predisposición Genética a la Enfermedad , Metaloproteinasa 2 de la Matriz/genética , Síndrome Mucocutáneo Linfonodular/genética , Polimorfismo de Nucleótido Simple , Enfermedad Aguda , Estudios de Casos y Controles , Preescolar , Estudios de Cohortes , Enfermedad Coronaria/complicaciones , Enfermedad Coronaria/fisiopatología , Femenino , Regulación de la Expresión Génica , Humanos , Masculino , Síndrome Mucocutáneo Linfonodular/complicaciones , Síndrome Mucocutáneo Linfonodular/fisiopatología , Análisis de Secuencia por Matrices de Oligonucleótidos/métodos , Probabilidad , ARN Mensajero , Valores de Referencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
5.
J Pediatr ; 145(3): 385-90, 2004 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15343196

RESUMEN

OBJECTIVE: To investigate whether the CD25 + CD4 + regulatory T-cell population, which plays important roles not only in maintaining immunologic self-tolerance but also in controlling the magnitude and character of antimicrobial immune responses, is related to the pathophysiology of Kawasaki disease (KD). STUDY DESIGN: The patient group consisted of 54 patients (median age, 30 months; 27 female and 27 male patients) fulfilling the criteria for KD. Age-matched control subjects included 17 patients with active infections and 24 healthy children. We analyzed CD25 + CD4 + cells and the mRNA expression of Foxp3, cytotoxic T lymphocyte-associated antigen 4 (CTLA4), glucocorticoid-induced tumor necrosis factor receptor (GITR), and transforming growth factor beta in peripheral blood mononuclear cells and purified CD4 + T cells. RESULTS: The proportions of CD25 + CD4 + cells in patients with acute-phase KD (median, 2.35% of total lymphocytes) were significantly lower than those in healthy control subjects (median, 3.14%) and control subjects with disease (median, 3.15%). The proportions returned to the normal level after intravenous gammaglobulin treatment (median, 3.86%). The mRNA expression of Foxp3, CTLA4, and GITR showed similar tendencies. CONCLUSIONS: The decrease of CD25 + CD4 + regulatory T cells in the acute phase might have a role in the development of KD.


Asunto(s)
Antígenos CD4/inmunología , Síndrome Mucocutáneo Linfonodular/inmunología , Receptores de Interleucina-2/inmunología , Antígenos CD4/sangre , Antígenos CD4/genética , Estudios de Casos y Controles , Preescolar , Femenino , Citometría de Flujo , Humanos , Masculino , Síndrome Mucocutáneo Linfonodular/genética , Síndrome Mucocutáneo Linfonodular/fisiopatología , Receptores de Interleucina-2/sangre , Receptores de Interleucina-2/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
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