A form of systemic vasculitis that affects mostly small and medium-sized vessels, Kawasaki disease (KD) is most commonly found in children under the age of 5 years old. Though its etiology is unknown, KD has been the most frequent acquired heart disease in developing countries. Its incidence has increased over recent decades in many centuries, including Japan, Korea, Taiwan and China. The most severe complications of KD are coronary artery lesions (CAL), including dilation, fistula, aneurysm, arterial remodeling, stenosis, and occlusion. Coronary artery dilation has been found in about 30% of KD patients in the acute stage, diminishing the occurrence and regression of CAL is a vital part of treating KD. Therefore, identifying KD during the 5-10 days of disease onset is very important to prevent coronary artery lesion. The clinical characteristics of KD include fever lasting for more than 5 days, as well as at least four of the following five symptoms: diffuse mucosal inflammation with strawberry tongue and fissure lips (1 mouth), bilateral non-purulent conjunctivitis (2 eyes), unilateral cervical lymphadenopathy (3 fingers check lymph node), indurative angioedema over the hands and feet (4 limbs), dysmorphic skin rashes (5 or more skin rashes). The diagnosis of KD is mainly depend on clinical symptoms, that will cause making a diagnosis more difficulty and more subjective. According to the literature review, there are not any one laboratory kit available till now for helping KD diagnosis in the world. We innovate the first laboratory method by using protein antibody array of Escherichia coli (E. Coli), that was a very powerful method published on (Nature Methods 2008. Jan;5(1):69-74) by Prof. Chien-Sheng Chen (our co-innovator). We took only 125 pl of plasma, that was accepted for published on (Molecular & Cellular Proteomics 2018 Mar;17(3):472-481). As the first report of E. Coli protein array in KD.
The innovation has a very impressive sensitivity, specificity, accuracy and area under curve (AUC) after training set and blind teat. The more than 80% accuracy and excellent to outstanding discrimination (> 0.8 AUC) results from this study may help clinician to diagnosis KD earlier and more precisely. Early detection and diagnosis is the most important factor in the treatment of KD, only diagnosis was making during 5-10 days of disease onset will diminish the incident of coronary artery complication. There are more than 1000 newly diagnosis KD in Taiwan, 20,000 new cases in Japan and almost 200,000 new KD patients in China every year. Every children have had fever more than 5 days need this E.coli protein antibody innovation to survey the possibility of KD for prevent lifelong complication. Children is the hope of country, protect the heart of children is protection the strong power of a nation.
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