Adjuvant herbal therapy for targeting susceptibility genes to Kawasaki disease: An overview of epidemiology, pathogenesis, diagnosis and pharmacological treatment of Kawasaki disease

Abstract

Background: Kawasaki disease (KD) is a self-limiting acute systemic vasculitis occur mainly in infants and young children under 5 years old. Although the use of acetylsalicylic acid (AAS) in combination with intravenous immunoglobulin (IVIG) remains the standard therapy to KD, the etiology, genetic susceptibility genes and pathogenic factors of KD are still un-elucidated.

Purpose: Current obstacles in the treatment of KD include the lack of standard clinical and genetic markers for early diagnosis, possible severe side effect of AAS (Reye's syndrome), and the refractory KD cases with resistance to IVIG therapy, therefore, this review has focused on introducing the current advances in the identification of genetic susceptibility genes, environmental factors, diagnostic markers and adjuvant pharmacological intervention for KD.

Results: With an overall update in the development of KD from different aspects, our current bioinformatics data has suggested CASP3, CD40 and TLR4 as the possible pathogenic factors or diagnostic markers of KD. Besides, a list of herbal medicines which may work as the adjunct therapy for KD via targeting different proposed molecular targets of KD have also been summarized.

Conclusion: With the aid of modern pharmacological research and technology, it is anticipated that novel therapeutic remedies, especially active herbal chemicals targeting precise clinical markers of KD could be developed for accurate diagnosis and treatment of the disease.

Keywords: AAS, acetylsalicylic acid; AHA, the American Heart Association; Adjuvant therapy; C IVIG, intravenous immunoglobulin; CALs, coronary artery lesions; CASP, caspase; CD, cluster of differentiation; CRP, C-reactive protein; DAVID, Database for Annotation, Visualization and Integrated Discovery; Diagnostic marker; Epidemiology; FCGR2A, Fc fragment of immunoglobulin G, low-affinity IIa; GWAS, genome-wide association method; HAdV, the human adenovirus; Herbal chemicals; IL, Interleukin; ITPKC, inositol 1,4,5-triphosphate 3-kinase; KD, Kawasaki disease; Kawasaki disease; MyD88, myeloid differentiation factor 88; NF-κB, nuclear factor κB; RS, Reye's syndrome; SNPs, single nucleotide polymorphisms; Susceptibility genes; TCMs, traditional Chinese medicines; TLR4, toll-like receptor 4; TNF, tumor necrosis factor; Th, T helper.