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Archives of Disease in Childhood 2006;91:847-851; doi:10.1136/adc.2005.087437
Copyright © 2006 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

REVIEW

The pathophysiology of coronary artery aneurysms in Kawasaki disease: role of matrix metalloproteinases

H Senzaki

Correspondence to:
Correspondence to:
Prof. Associate H Senzaki
Department of Pediatric Cardiology, Saitama Heart Institute, Saitama Medical University Hospital, 38 Morohongo, Moroyama, Saitama 350-0495, Japan; hsenzaki{at}saitama-med.ac.jp

ABSTRACT

Kawasaki disease is an acute inflammatory syndrome that takes the form of systemic vasculitis, and predominantly affects children. Important complications of this disease are coronary artery dilation and aneurysm formation. Recent studies indicate that Kawasaki disease patients have elevated expression, activity, or protein levels of matrix metalloproteinases (MMPs), and suggest that imbalances in MMPs or MMP/tissue inhibitor of MMP (TIMP) play important pathophysiological roles in the development of coronary artery lesions in this disease. However, it remains unclear whether MMP activities at the site of coronary artery lesions are indeed increased. Further studies on the effects of MMP inhibition on coronary outcome are needed to define the roles of MMPs and TIMPs in the formation of coronary artery lesions in Kawasaki disease; findings of such studies may support the use of MMP inhibitors for the prevention of coronary artery complications in patients with this disease.

Abbreviations: CAL, coronary artery lesion; IVGG, intravenous gammaglobulin; MMP, metalloproteinase; TIMP, tissue inhibitor of MMP

Keywords: Kawasaki disease; coronary artery aneurism; matrix metalloproteinases; pathophysiology


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