Specific Proteins in Urine Help Diagnose Kawasaki Disease

A set of proteins detected in urine of patients with Kawasaki disease could make the disease easier to diagnose and give doctors an opportunity to start treatment earlier.

Susan Kim, MD, MMSc, a rheumatologist with the Kawasaki Disease Program at Boston Children’s Hospital (Boston, MA, USA) worked with proteomics experts Alex Kentsis, MD, PhD, and Hanno Steen, PhD, to screen the protein content of urine from patients with Kawasaki disease using mass spectrometry and enzyme-linked immunosorbant assays.

The team identified 190 proteins found only in the urine of children with Kawasaki disease. When validated in samples from 107 children seen at Boston Children’s with suspected Kawasaki disease (53 of whom were ultimately diagnosed with it), two of the proteins—filamin C and meprin A, which are associated with injury to blood vessel and cardiac muscle cells as well as inflammation—proved to be 98% accurate at distinguishing children with Kawasaki disease from ones with conditions mimicking the disease. Levels of the markers also closely tracked treatment response and in one patient, disease recurrence

Other Kawasaki-associated markers detected in the study included proteins involved in immune activation, immune regulation, and pathogen recognition. The researchers caution that for the moment the markers are still research tools and that they are working to refine and validate the findings in a larger group of patients.

The discovery was reported online by a team led by members of the proteomics center and the departments of pathology and rheumatology at Boston Children’s Hospital on December 20, 2012, in the journal EMBO Molecular Medicine.

Kawasaki disease is an uncommon but increasingly prevalent disease, which causes inflammation of blood vessels that can lead to enlarged coronary arteries and even heart attacks in some children. While only about two in 10,000 children in the United States develop Kawasaki disease annually, the disease is on the rise worldwide; in Japan the prevalence approaches one in 100 among children under the age of five. No one knows what triggers the disease, and though it can occur at any age, it most often appears in children under five.

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