Journal List > Allergy Asthma Respir Dis > v.7(4) > 1138007

Allergy Asthma Respir Dis. 2019 Oct;7(4):173-178. Korean.
Published online Oct 30, 2019.  https://doi.org/10.4168/aard.2019.7.4.173
© 2019 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
The association between asthma and Kawasaki disease
Bong Seok Choi
Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.

Correspondence to: Bong Seok Choi. Department of Pediatrics, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea. Tel: +82-53-200-5704, Fax: +82-53-425-6683, Email: bschoi@knu.ac.kr
Received Mar 14, 2019; Revised Sep 11, 2019; Accepted Sep 11, 2019.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).


Abstract

Kawasaki disease (KD) is a systemic vasculitis and the most common cause of acquired heart disease among preschool-aged children. Asthma is one of the most common chronic illness of childhood. There is increasing interest in the potential link between inflammatory diseases and allergic diseases, and there is increasing epidemiologic evidence for an association of KD and allergic disease. In regards to asthma, 9 studies have been reported about its association with KD; 5 of them showed positive associations between these 2 diseases, while 4 of them showed no association. There are some possible underlying mechanisms for this association. The serum IgE levels are found to be increased and there is a Th2-predominant immune response in KD. These are common findings of asthma. Human leukocyte antigen-G/regT cells and SMAD3/transforming growth factor-beta might also be involved in the pathogenesis of both diseases. Asthma may increase susceptibility to KD and tends to lead to immune dysregulation. Clinician's recognition of the increased risks of KD and other asthma-related comorbidities among patients with asthma may enable early identification and intervention. The early identification and management of comorbidities may ultimately reduce the economic and social burden of these chronic conditions.

Keywords: Kawasaki disease; Mucocutaneous lymph node syndrome; Allergy; Asthma; Comorbidity

Tables


Table 1
Studies showing an association between asthma and the risk of Kawasaki disease
Click for larger imageClick for full tableDownload as Excel file


Table 2
Studies showing no association between asthma and the risk of Kawasaki disease
Click for larger imageClick for full tableDownload as Excel file

References
1. Kim GB, Park S, Eun LY, Han JW, Lee SY, Yoon KL, et al. Epidemiology and clinical features of Kawasaki disease in South Korea, 2012-2014. Pediatr Infect Dis J 2017;36:482–485.
2. Kato H, Sugimura T, Akagi T, Sato N, Hashino K, Maeno Y, et al. Long-term consequences of Kawasaki disease. A 10- to 21-year follow-up study of 594 patients. Circulation 1996;94:1379–1385.
3. Dajani AS, Taubert KA, Gerber MA, Shulman ST, Ferrieri P, Freed M, et al. Diagnosis and therapy of Kawasaki disease in children. Circulation 1993;87:1776–1780.
4. Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004;110:2747–2771.
5. Chang RK. The incidence of Kawasaki disease in the United States did not increase between 1988 and 1997. Pediatrics 2003;111(5 Pt 1):1124–1125.
6. Holman RC, Curns AT, Belay ED, Steiner CA, Schonberger LB. Kawasaki syndrome hospitalizations in the United States, 1997 and 2000. Pediatrics 2003;112(3 Pt 1):495–501.
7. Maddox RA, Holman RC, Uehara R, Callinan LS, Guest JL, Schonberger LB, et al. Recurrent Kawasaki disease: USA and Japan. Pediatr Int 2015;57:1116–1120.
8. To T, Stanojevic S, Moores G, Gershon AS, Bateman ED, Cruz AA, et al. Global asthma prevalence in adults: findings from the cross-sectional world health survey. BMC Public Health 2012;12:204
9. Lee SI. Prevalence of childhood asthma in Korea: international study of asthma and allergies in childhood. Allergy Asthma Immunol Res 2010;2:61–64.
10. Braman SS. The global burden of asthma. Chest 2006;130(1 Suppl):4S–12S.
11. Murray CJ, Atkinson C, Bhalla K, Birbeck G, Burstein R, Chou D, et al. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA 2013;310:591–608.
12. Wills-Karp M. Immunologic basis of antigen-induced airway hyperresponsiveness. Annu Rev Immunol 1999;17:255–281.
13. Kwon HJ, Bang DW, Kim EN, Wi C, Yawn BP, Wollan PC, et al. Asthma as a risk factor for zoster in adults: a population-based case-control study. J Allergy Clin Immunol 2016;137:1406–1412.
14. Wi CI, Kim BS, Mehra S, Yawn BP, Park MA, Juhn YJ. Risk of herpes zoster in children with asthma. Allergy Asthma Proc 2015;36:372–378.
15. Sheen YH, Rolfes MC, Wi CI, Crowson CS, Pendegraft RS, King KS, et al. Association of asthma with rheumatoid arthritis: a population-based case-control study. J Allergy Clin Immunol Pract 2018;6:219–226.
16. Bang DW, Wi CI, Kim EN, Hagan J, Roger V, Manemann S, et al. Asthma status and risk of incident myocardial infarction: a population-based case-control study. J Allergy Clin Immunol Pract 2016;4:917–923.
17. Patel B, Wi CI, Hasassri ME, Divekar R, Absah I, Almallouhi E, et al. Heterogeneity of asthma and the risk of celiac disease in children. Allergy Asthma Proc 2018;39:51–58.
18. Brosius CL, Newburger JW, Burns JC, Hojnowski-Diaz P, Zierler S, Leung DY. Increased prevalence of atopic dermatitis in Kawasaki disease. Pediatr Infect Dis J 1988;7:863–866.
19. Matsuoka S, Tatara K, Nakagawa R, Mori K, Kuroda Y. Tendency toward atopy in Kawasaki disease. Eur J Pediatr 1997;156:30–32.
20. Liew WK, Lim CW, Tan TH, Wong KY, Tai BC, Quek SC, et al. The effect of Kawasaki disease on childhood allergies - a sibling control study. Pediatr Allergy Immunol 2011;22:488–493.
21. Webster RJ, Carter KW, Warrington NM, Loh AM, Zaloumis S, Kuijpers TW, et al. Hospitalisation with infection, asthma and allergy in Kawasaki disease patients and their families: genealogical analysis using linked population data. PLoS One 2011;6:e28004
22. Kuo HC, Chang WC, Yang KD, Yu HR, Wang CL, Ho SC, et al. Kawasaki disease and subsequent risk of allergic diseases: a population-based matched cohort study. BMC Pediatr 2013;13:38
23. Woon PY, Chang WC, Liang CC, Hsu CH, Klahan S, Huang YH, et al. Increased risk of atopic dermatitis in preschool children with kawasaki disease: a population-based study in taiwan. Evid Based Complement Alternat Med 2013;2013:605123
24. Hwang CY, Hwang YY, Chen YJ, Chen CC, Lin MW, Chen TJ, et al. Atopic diathesis in patients with Kawasaki disease. J Pediatr 2013;163:811–815.
25. Tsai YJ, Lin CH, Fu LS, Fu YC, Lin MC, Jan SL. The association between Kawasaki disease and allergic diseases, from infancy to school age. Allergy Asthma Proc 2013;34:467–472.
26. Hassidim A, Merdler I, Chorin O, Merdler-Rabinowicz R, Dallal I, Perlman M, et al. Atopic predilection among Kawasaki disease patients: a cross-sectional study of 1,187,757 teenagers. Int Arch Allergy Immunol 2016;170:92–96.
27. Nakamura T, Nakamura T, Ko G, Yamashita Y, Akita C, Saikawa Y. Over 5 years follow-up of kawasaki disease with atopic bronchial asthma. Circulation 2015;131 suppl 2
Abstract No. 205.
28. Wei CC, Lin CL, Kao CH, Liao YH, Shen TC, Tsai JD, et al. Increased risk of Kawasaki disease in children with common allergic diseases. Ann Epidemiol 2014;24:340–343.
29. Masood S, Manlhiot C, Chahal N, Yeung R, Mccrindle B. Environmental exposures and Kawasaki disease: the infectious trigger hypothesis. Pediatr Int 2012;54:64.
30. White SR, Loisel DA, Stern R, Laxman B, Floreth T, Marroquin BA. Human leukocyte antigen-G expression in differentiated human airway epithelial cells: lack of modulation by Th2-associated cytokines. Respir Res 2013;14:4
31. Carlini F, Picard C, Garulli C, Piquemal D, Roubertoux P, Chiaroni J, et al. Bronchial epithelial cells from asthmatic patients display less functional HLA-G isoform expression. Front Immunol 2017;8:6
32. Kim JJ, Hong SJ, Hong YM, Kim S, Kang MJ, Kim KJ, et al. Genetic variants in the HLA-G region are associated with Kawasaki disease. Hum Immunol 2008;69:867–871.
33. Ni FF, Li CR, Li Q, Xia Y, Wang GB, Yang J. Regulatory T cell microRNA expression changes in children with acute Kawasaki disease. Clin Exp Immunol 2014;178:384–393.
34. Howell JE, McAnulty RJ. TGF-beta: its role in asthma and therapeutic potential. Curr Drug Targets 2006;7:547–565.
35. Makinde T, Murphy RF, Agrawal DK. The regulatory role of TGF-beta in airway remodeling in asthma. Immunol Cell Biol 2007;85:348–356.
36. Shimizu C, Jain S, Davila S, Hibberd ML, Lin KO, Molkara D, et al. Transforming growth factor-beta signaling pathway in patients with Kawasaki disease. Circ Cardiovasc Genet 2011;4:16–25.
37. Shimizu C, Oharaseki T, Takahashi K, Kottek A, Franco A, Burns JC. The role of TGF-β and myofibroblasts in the arteritis of Kawasaki disease. Hum Pathol 2013;44:189–198.
38. Kuo HC, Wang CL, Liang CD, Yu HR, Huang CF, Wang L, et al. Association of lower eosinophil-related T helper 2 (Th2) cytokines with coronary artery lesions in Kawasaki disease. Pediatr Allergy Immunol 2009;20:266–272.
39. Furukawa S, Matsubara T, Motohashi T, Sasai K, Nakachi S, Umezawa Y, et al. Increased expression of Fc epsilon R2/CD23 on peripheral blood B lymphocytes and serum IgE levels in Kawasaki disease. Int Arch Allergy Appl Immunol 1991;95:7–12.
40. Terai M, Yasukawa K, Honda T, Jibiki T, Hirano K, Sato J, et al. Peripheral blood eosinophilia and eosinophil accumulation in coronary microvessels in acute Kawasaki disease. Pediatr Infect Dis J 2002;21:777–781.
41. Parks WC, Shapiro SD. Matrix metalloproteinases in lung biology. Respir Res 2001;2:10–19.
42. Gualano RC, Vlahos R, Anderson GP. What is the contribution of respiratory viruses and lung proteases to airway remodelling in asthma and chronic obstructive pulmonary disease? Pulm Pharmacol Ther 2006;19:18–23.
43. Wark PA, Johnston SL, Moric I, Simpson JL, Hensley MJ, Gibson PG. Neutrophil degranulation and cell lysis is associated with clinical severity in virus-induced asthma. Eur Respir J 2002;19:68–75.
44. Biezeveld MH, van Mierlo G, Lutter R, Kuipers IM, Dekker T, Hack CE, et al. Sustained activation of neutrophils in the course of Kawasaki disease: an association with matrix metalloproteinases. Clin Exp Immunol 2005;141:183–188.