Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distribution.
Environmental epidemiology of Kawasaki disease: Linking disease etiology, pathogenesis and global distribution.
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DOI：
10.1371/journal.pone.0191087
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
McCrindle BW
中科院分区：
文献类型：
--
作者：
Manlhiot C;Mueller B;O'Shea S;Majeed H;Bernknopf B;Labelle M;Westcott KV;Bai H;Chahal N;Birken CS;Yeung RSM;McCrindle BW
川崎病(KD)的发病机制通常归因于易感儿童对不明环境或感染因素的过度免疫反应。尚未提出将流行病学数据和KD全球分布联系起来的全面框架。KD患者(n=81)和对照组(n=87)在确诊后6周内入选。所有人都完成了一份广泛的流行病学调查问卷。地理定位软件以受试者的社区为特征。KD发病率与大气生物颗粒物计数和风型进行了比较。这些数据被用来创建KD的全面风险框架，我们对照已公布的全球分布数据对其进行了测试。与对照组相比，KD患者更有可能是亚洲血统，更有可能生活在环境过敏原暴露较低的环境中。大气中真菌/孢子以外的生物颗粒的数量越多，KD的发病率就越低。最后，西风与大气中真菌颗粒的增加和大多伦多地区KD发病率的增加有关。我们提出的框架能够解释KD全球分布中大约80%的变异。这项研究的主要局限性是，这项研究中使用的大多数数据仅限于加拿大的背景，我们提出的疾病框架是理论和间接的，而不是单一模拟的结果。我们提出的病因学框架包括：1)遗传易感人群的比例；2)风险的调节，由习惯性暴露于环境过敏原、大气生物颗粒的季节变化和接触传染病确定；以及3)暴露于假定的触发因素。考虑到所有这些非传统因素，将加强对个人风险和全球分布的未来建模。
The pathogenesis of Kawasaki disease (KD) is commonly ascribed to an exaggerated immunologic response to an unidentified environmental or infectious trigger in susceptible children. A comprehensive framework linking epidemiological data and global distribution of KD has not yet been proposed. Patients with KD (n = 81) were enrolled within 6 weeks of diagnosis along with control subjects (n = 87). All completed an extensive epidemiological questionnaire. Geographic localization software characterized the subjects’ neighborhood. KD incidence was compared to atmospheric biological particles counts and winds patterns. These data were used to create a comprehensive risk framework for KD, which we tested against published data on the global distribution. Compared to controls, patients with KD were more likely to be of Asian ancestry and were more likely to live in an environment with low exposure to environmental allergens. Higher atmospheric counts of biological particles other than fungus/spores were associated with a temporal reduction in incidence of KD. Finally, westerly winds were associated with increased fungal particles in the atmosphere and increased incidence of KD over the Greater Toronto Area. Our proposed framework was able to explain approximately 80% of the variation in the global distribution of KD. The main limitations of the study are that the majority of data used in this study are limited to the Canadian context and our proposed disease framework is theoretical and circumstantial rather than the result of a single simulation. Our proposed etiologic framework incorporates the 1) proportion of population that are genetically susceptible; 2) modulation of risk, determined by habitual exposure to environmental allergens, seasonal variations of atmospheric biological particles and contact with infectious diseases; and 3) exposure to the putative trigger. Future modelling of individual risk and global distribution will be strengthened by taking into consideration all of these non-traditional elements.
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DOI：
10.1097/inf.0b013e31817acf4f
发表时间：
2008-11
期刊：
The Pediatric infectious disease journal
影响因子：
--
作者：
Kao AS;Getis A;Brodine S;Burns JC
通讯作者：
Burns JC
DOI：
10.1098/rspb.2011.2464
发表时间：
2012-07-22
影响因子：
4.7
作者：
Pitzer, Virginia E.;Burgner, David;Lipsitch, Marc
通讯作者：
Lipsitch, Marc
影响因子：
4.7
作者：
Nakamura, Yosikazu;Yashiro, Mayumi;Yanagawa, Hiroshi
通讯作者：
Yanagawa, Hiroshi
经常性川崎病：美国和日本。
DOI：
10.1111/ped.12733
发表时间：
2015-12
期刊：
Pediatrics international : official journal of the Japan Pediatric Society
影响因子：
--
作者：
Maddox RA;Holman RC;Uehara R;Callinan LS;Guest JL;Schonberger LB;Nakamura Y;Yashiro M;Belay ED
通讯作者：
Belay ED
影响因子：
11.8
作者：
Jorquera, Hector;Borzutzky, Arturo;Garcia, Alvaro
通讯作者：
Garcia, Alvaro