The rs1051931 G>A Polymorphism in the PLA2G7 Gene Confers Resistance to Immunoglobulin Therapy in Kawasaki Disease in a Southern Chinese Population

Background: Kawasaki disease (KD) is a common cardiovascular disease in infants and young children, with fever, rash and conjunctivitis as the main clinical manifestations, which can lead to the occurrence of coronary aneurysms. Intravenous immunoglobulin (IVIG) is the preferred treatment for KD, but 10-20% of patients are resistant to IVIG. Lp-PLA2 is a potential therapeutic target for coronary atherosclerotic heart disease, and the polymorphism of PLA2G7 is closely related to the activity of Lp-PLA2, of which rs1051931 is the strongest. Therefore, the rs1051931 polymorphism may be a predictor of IVIG resistance in KD patients. Methods: A total of 760 KD cases, including 148 IVIG-resistant patients and 612 IVIG-responsive patients, were analysed by odds ratios (OR) and 95% confidence interval (CI). Results: The homozygous mutation AA may be a protective factor for IVIG resistance in KD patients (adjusted OR=3.47, 95% CI=1.14-10.57, P =0.0284) and is more evident in patients with KD aged less than 60 months (adjusted OR=3.68, 95% CI=1.10–12.28, P=0.0399). Conclusions: The PLA2G7 rs1051931 G>A polymorphism may be suitable as a biomarker for the diagnosis or prognosis of IVIG resistance in KD in a southern Chinese population.