Serum Levels of Syndecan-1 in Patients With Kawasaki Disease

Background: Kawasaki disease (KD) is an acute systemic vasculitis with coronary artery lesions (CALs) being the major concern. Syndecan-1 (SDC-1) is a major core protein expressed on the glycocalyx of endothelial cells. Shed SDC-1 in serum is regarded as a biomarker for endothelial activation or damage. Methods: In this study, we aimed to determine the serum levels of SDC-1 and evaluate the relationship between serum levels of SDC-1 and the CALs in the acute phase of KD. Serum SDC-1 levels were measured in 119 children with KD and in 43 healthy children as normal controls and in 40 children with febrile disease. All KD patients were administrated a single dose of intravenous immunoglobulin (IVIG) and aspirin P.O. within 10 days of KD onset. Results: Serum levels of SDC-1, in addition to albumin and hemoglobin were significantly increased in patients with KD than in healthy controls and febrile controls. Furthermore, the serum levels of syndecan-1, albumin, and hemoglobin were significantly elevated in KD patients with CALs than those without CALs. Additionally, serum levels of SDC-1 were significantly correlated with levels of hemoglobin and serum albumin in patients with KD. After IVIG therapy, serum levels of interleukin (IL)-6, soluble cell adhesion molecules-1(sICAM-1), and resisitin were reduced while serum levels of SDC-1 were significantly increased in KD patients. Conclusion: SDC-1 serum levels may mirror vascular endothelial damage and inflammation in KD. This might be utilized as a potential novel target for coronary artery protection in KD patients.