A diagnostic algorithm combining clinical and molecular data distinguishes Kawasaki disease from other febrile illnesses.
A diagnostic algorithm combining clinical and molecular data distinguishes Kawasaki disease from other febrile illnesses.
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DOI：
10.1186/1741-7015-9-130
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发表时间：
2011-12-06
期刊：
影响因子：
9.3
通讯作者：
Cohen HJ
中科院分区：
文献类型：
--
作者：
Ling XB;Lau K;Kanegaye JT;Pan Z;Peng S;Ji J;Liu G;Sato Y;Yu TT;Whitin JC;Schilling J;Burns JC;Cohen HJ
川崎是一种急性血管炎的婴儿和幼儿，是认识到通过一系列的临床体征，可以模仿其他良性条件的儿童。病因仍然不明，也没有特定的实验室检测来识别川崎患者。预防冠状动脉瘤并发症的治疗最有效的方法是在疾病的早期进行。我们试图开发一种诊断算法，以帮助临床医生区分川崎病患者和发热对照，以便及时开始治疗。将尿肽组分析和全血细胞类型特异性基因表达分析与临床多变量分析相结合，以提高川崎受试者与发热对照的区分度。使用23个合并的川崎病和23个合并的发热对照尿肽样本进行多维蛋白质鉴定的比较分析，揭示了139个候选标志物，其中13个在30个川崎病和30个发热对照尿肽组的独立队列中得到确认（受试者工作特征曲线下的面积（ROC AUC 0.919））。对26例川崎患者和13例发热对照全血样本进行细胞类型特异性微阵列分析（csSAM），发现32个淋巴细胞特异性基因组（ROC AUC 0.969）。基于尿/血液的生物标志物组的整合和7个临床参数的多变量分析（ROC AUC 0.803）有效地将441名川崎病受试者和342名发热对照受试者分层以诊断川崎病。采用多步骤诊断算法结合临床和分子结果的混合方法成功地将急性川崎病患儿与发热对照儿童区分开来。
Kawasaki disease is an acute vasculitis of infants and young children that is recognized through a constellation of clinical signs that can mimic other benign conditions of childhood. The etiology remains unknown and there is no specific laboratory-based test to identify patients with Kawasaki disease. Treatment to prevent the complication of coronary artery aneurysms is most effective if administered early in the course of the illness. We sought to develop a diagnostic algorithm to help clinicians distinguish Kawasaki disease patients from febrile controls to allow timely initiation of treatment. Urine peptidome profiling and whole blood cell type-specific gene expression analyses were integrated with clinical multivariate analysis to improve differentiation of Kawasaki disease subjects from febrile controls. Comparative analyses of multidimensional protein identification using 23 pooled Kawasaki disease and 23 pooled febrile control urine peptide samples revealed 139 candidate markers, of which 13 were confirmed (area under the receiver operating characteristic curve (ROC AUC 0.919)) in an independent cohort of 30 Kawasaki disease and 30 febrile control urine peptidomes. Cell type-specific analysis of microarrays (csSAM) on 26 Kawasaki disease and 13 febrile control whole blood samples revealed a 32-lymphocyte-specific-gene panel (ROC AUC 0.969). The integration of the urine/blood based biomarker panels and a multivariate analysis of 7 clinical parameters (ROC AUC 0.803) effectively stratified 441 Kawasaki disease and 342 febrile control subjects to diagnose Kawasaki disease. A hybrid approach using a multi-step diagnostic algorithm integrating both clinical and molecular findings was successful in differentiating children with acute Kawasaki disease from febrile controls.
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影响因子：
13.6
作者：
Ling, Xuefeng B.;Sigdel, Tara K.;Sarwal, Minnie M.
通讯作者：
Sarwal, Minnie M.
影响因子：
37.8
作者：
Senzaki, H;Masutani, S;Yokote, Y
通讯作者：
Yokote, Y
影响因子：
4.6
作者：
Takeshita, S;Dobashi, H;Yoshioka, S
通讯作者：
Yoshioka, S
影响因子：
5.1
作者：
KOREN, G;SILVERMAN, E;BURNS, JC
通讯作者：
BURNS, JC
DOI：
10.1086/603538
发表时间：
2009-08-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Popper SJ;Watson VE;Shimizu C;Kanegaye JT;Burns JC;Relman DA
通讯作者：
Relman DA