What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Kawasaki disease (n=198). Intervention: Peripheral blood Th17/Treg ratio vs. Lower Th17/Treg ratio. Primary outcome: Development of coronary artery lesions (CALs) (OR 1.625, 95% CI 1.228-2.151, p=0.001).

October 14, 2025BMC Immunology3 citationsOpen Access

Correlation between peripheral blood Th17/Treg immune imbalance and coronary artery lesions in children with Kawasaki disease

YWYanjun Wu FZFeng Zhu

Key Result

An elevated peripheral blood Th17/Treg ratio is an independent risk factor for coronary artery lesions in children with Kawasaki disease (OR 1.625) and demonstrates high diagnostic value (AUC 0.856).

Study Design

Type

Cross-Sectional (n=198)

Multicenter

Structured PICO

Does peripheral blood Th17/Treg immune imbalance correlate with coronary artery lesions in children with Kawasaki disease?

Population

198 children under 16 years of age with an initial diagnosis of Kawasaki disease, evaluated for coronary artery lesions prior to intravenous immunoglobulin treatment.

Outcome

Correlation of peripheral blood Th17/Treg with coronary arterial internal diameter and IL-6, and diagnostic value of Th17/Treg for coronary artery lesions (CALs)surrogate

Peripheral blood Th17/Treg ratio > 71.56% is an independent risk factor and effective diagnostic biomarker for coronary artery lesions in children with Kawasaki disease.

Main Result

Odds Ratio: 1.625 (95% CI 1.228–2.151)

p-value: p=0.001

Limitations

Cross-sectional design limits causal inference
Potential unmeasured confounding factors such as genetic susceptibility and environmental exposure
Single-center study with potential selection bias
Did not explore differences between complete and incomplete Kawasaki disease
The diagnostic threshold of 71.56% may not be applicable to other populations or stages of the disease
Deep molecular mechanisms underlying the immune imbalance were not explored

Abstract

OBJECTIVE: Coronary artery lesions (CALs) are a specified feature of Kawasaki disease (KD), occurring in the second week of onset. The current study was to unravel the correlation between peripheral blood T helper 17/regulatory T (Th17/Treg) immune imbalance and CALs in children with KD. METHODS: In this cross-sectional study, 198 KD children were evaluated for their CALs as per the coronary arterial internal diameter, and allocated into the CAL and non-CAL groups, with their general baseline data and laboratory parameters collected. Peripheral blood Th17 and Treg were measured by flow cytometry, with Th17/Treg calculated. The correlations of peripheral blood Th17/Treg with the coronary arterial internal diameter and interleukin (IL)-6, the diagnostic value of neutrophil-lymphocyte ratio (NLR) and peripheral blood Th17/Treg for CALs, and the independent risk factors for CALs in KD children were analyzed by the Spearman’s, receiver operating characteristic curve and multivariate logistic regression analyses, respectively. RESULTS: NLR, C-reactive protein, IL-6, and Th17/Treg levels and percentage of anemia were higher in CAL children than in those with non-CAL (all P 71.56% had high diagnostic value for CALs in KD children (area under the curve: 0.856). Peripheral blood Th17/Treg was an independent risk factor for CALs in KD children (P 71.56% is effective in diagnosing CALs in KD children. Th17/Treg is an independent risk factor for CALs.

问 AI

Bookmark

View Full Paper