A major pediatric research priority and the long-term goal of my laboratory is the identification of the etiology and pathogenesis of Kawasaki Disease (KD), the leading cause of acquired heart disease in children in developed nations. KD can result in coronary artery aneurysm (CAA) formation with resultant myocardial infarction and/or sudden death. Clinical and epidemiologic data are consistent with an infectious cause of KD, but the etiologic agent remains unknown.We hypothesize that a "new" virus enters through the respiratory tract and infects bronchial epithelium, traveling in macrophages to targeted tissues including coronary arteries.
We recently showed that the immune transcriptome of KD coronary arteritis has features of an antiviral immune response such as activated cytotoxic T lymphocyte and type I interferon-induced gene upregulation, which can guide selection of new immunomodulatory therapies for high-risk KD patients.
Our prior extensive pathologic study identified chronic arteritis in KD children with severe coronary artery disease, challenging the previously held dogma of KD as solely an acute arteritis.
We are currently cloning and expressing specific oligoclonal antibodies from KD patients and using them as tools to identify antigens important in pathogenesis.
Anne Rowley, MD
Professor of Pediatrics and Microbiology/Immunology, Northwestern University Feinberg School of Medicine; Attending physician, Division of Infectious Diseases, Lurie Children's