Association Between Thymosin β4 and Coronary Arterial Lesions in Children with Kawasaki Disease

Background: Kawasaki disease (KD) is an acute systemic vasculitis primarily affecting children and is a leading cause of acquired heart disease in developed countries. Recently, an increasing number of studies have demonstrated the close correlations between inflammation and KD. Thymosin β4 (Tβ4) has been reported to play a role in cardiovascular protection and repair by modulating inflammation, angiogenesis, and endothelial function. However, its role in KD still remains poorly understood. This study aims to explore the potential involvement of Tβ4 in the pathogenesis of KD, with a particular focus on its relationship to inflammation and coronary artery lesions (CALs). Methods: Serum Tβ4 levels were measured using enzyme-linked immunosorbent assay (ELISA) in children with KD and age-matched healthy controls. The KD group was further categorized into patients with and without CALs. Correlation analyses were performed between Tβ4 levels and clinical or laboratory parameters. Results: Serum Tβ4 levels were significantly lower in patients with KD compared to healthy controls and were further reduced in patients with CALs. After intravenous immunoglobulin (IVIG) treatment, Tβ4 levels significantly increased. Tβ4 levels were negatively correlated with several pro-inflammatory (eg, TNF-α, IL-1β) and anti-inflammatory cytokines (eg, IL-4, IL-10). Conclusion: Tβ4 levels were significantly lower in children with KD, particularly in those with CALs. These findings suggest that Tβ4 may be involved in the inflammatory pathogenesis of KD and the progression of CALs, thus could represent a potential target for future diagnostic or therapeutic interventions.