AUTHOR=Yu Hongyan , Liu Fucheng , Chen Kaining , Xu Yufen , Wang Yishuai , Fu Lanyan , Zhou Huazhong , Pi Lei , Che Di , Li Hehong , Gu Xiaoqiong 

TITLE=The EIF2AK4/rs4594236 AG/GG Genotype Is a Hazard Factor of Immunoglobulin Therapy Resistance in Southern Chinese Kawasaki Disease Patients

JOURNAL=Frontiers in Genetics

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/genetics/articles/10.3389/fgene.2022.868159

DOI=10.3389/fgene.2022.868159

ISSN=1664-8021

ABSTRACT=<p><bold>Background:</bold> Kawasaki disease (KD) is an acute, self-limited vasculitis disorder of unknown etiology in children. Immunologic abnormalities were detected during the acute phase of KD, which reflected that the effect cells of the activated immune system markedly increased cytokine production. High-dose intravenous immunoglobulin (IVIG) therapy is effective in resolving inflammation from KD and reducing occurrence of coronary artery abnormalities. However, 10%–20% of KD patients have no response to IVIG therapy, who were defined as IVIG resistance. Furthermore, these patients have persistent inflammation and increased risk of developing coronary artery aneurysm (CAA). <italic>EIF2AK4</italic> is a stress sensor gene and can be activated by pathogen infection. In addition, the polymorphisms of <italic>EIF2AK4</italic> were associated with various blood vessel disorders. However, it remains unclear whether the <italic>EIF2AK4</italic> gene polymorphisms were related to IVIG therapy outcome in KD patients.</p><p><bold>Methods:</bold><italic>EIF2AK4/</italic>rs4594236 polymorphism was genotyped in 795 IVIG response KD patients and 234 IVIG resistant KD patients through TaqMan, a real-time polymerase chain reaction. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the strength of association between <italic>EIF2AK4/</italic>rs4594236 polymorphism and IVIG therapeutic effects.</p><p><bold>Results:</bold> Our results showed that the <italic>EIF2AK4</italic>/rs4594236 AG/GG genotype was significantly associated with increased risk to IVIG resistance compared to the AA genotype (AG vs. AA: adjusted ORs = 1.71, 95% CIs = 1.17–2.51, and <italic>p</italic> = 0.0061; GG vs. AA: adjusted ORs = 2.09, 95% CIs = 1.36–3.23, and <italic>p</italic> = 0.0009; AG/GG vs. AA: adjusted ORs = 1.82, 95% CIs = 1.27–2.63, and <italic>p</italic> = 0.0013; and GG vs. AA/AG: adjusted ORs = 1.45, 95% CI = 1.04–2.02, and <italic>p</italic> = 0.0306). Furthermore, the stratified analysis of age and gender in the KD cohort indicated that male patients carrying the rs4594236 AG/GG genotype tends to be more resistant to IVIG therapy than female patients.</p><p><bold>Conclusion:</bold> These results suggested that <italic>EIF2AK4/</italic>rs4594236 polymorphism might be associated with increased risk of IVIG resistance in southern Chinese KD patients.</p>