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A dual covariant biomarker approach to Kawasaki disease, using vascular endothelial growth factor A and B gene expression; implications for coronary pathogenesis

Rashid, Asrar; Benakatti, Govind; Al-Obeidat, Feras; Phatak, Rajesh; Malik, Zainab A.; Sharief, Javed; Kadwa, Raziya; Hafez, Wael; Toufiq, Mohammed; Chaussabel, Damien; Malik, Rayaz; Quraishi, Nasir; Zaki, Syed Ahmed; Shaikh, Guftar; Hussain, Amir


Asrar Rashid

Govind Benakatti

Feras Al-Obeidat

Rajesh Phatak

Zainab A. Malik

Javed Sharief

Raziya Kadwa

Wael Hafez

Mohammed Toufiq

Damien Chaussabel

Rayaz Malik

Nasir Quraishi

Syed Ahmed Zaki

Guftar Shaikh


Kawasaki disease (KD) is the most common vasculitis in young children, with coronary artery lesions (CALs) and coronary aneurysms (CAAs) being responsible for most KD-related deaths.

We hypothesized that Vascular Endothelial Growth Factors (VEGFs) are pivotal in KD inflammation and coronary artery lesions. This study assessed VEGF-A and VEGF-B gene expression (GE) as potential biomarkers in KD inflammation.

Study design
We analyzed NCBI-GEO datasets, categorizing gene expression patterns as "inflammatory" or "non-inflammatory". We focused on TNF-, NFKB1, VEGF-A, and VEGF-B GEs. Datasets were filtered based on differential changes in TNF and NFKB1 levels to isolate those with inflammatory shifts.

Inflammatory datasets (GSE63881, GSE73464, and GSE68004) displayed elevated TNF, NFKB1, and VEGF-A GE levels during acute KD. VEGF-B GE exhibited a distinctive trend: an initial drop and subsequent rise during recovery, a pattern that was missing in the non-inflammatory group. The treatment response was also studied, with intravenous immunoglobulin (IVIG) responders showing significant downregulation of NFKB1 GE after treatment: GSE16797 [IVIG ± methylprednisolone; p = 8.6443-03], GSE48498 [IVIG; p = 6.618e-02, infliximab; p = 3.240e-03], and GSE18606 [IVIG; p = 3.518e-02]. Considering the similar binding of VEGF-A and VEGF-B to the VEGFR1 receptor, a co-variate and inverse relationship is suggested.

Temporal VEGF-A, VEGF-B, and GE changes show promise as new post-inflammatory biomarkers for KD. Novelty results with the biomarker approach, with the potential for a dual temporal relationship between VEGF-A and VEGF-A. A comprehensive exploration of VEGF-A and VEGF-B genes and protein analysis in KD is warranted to understand the functional aspects of these changes and how best to utilize the pattern of changes for therapeutic benefit.

Journal Article Type Article
Acceptance Date Oct 17, 2023
Online Publication Date Oct 21, 2023
Publication Date 2023
Deposit Date Jan 5, 2024
Publicly Available Date Jan 5, 2024
Journal Informatics in Medicine Unlocked
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 43
Article Number 101384
Keywords Temporal, Kawasaki disease, Gene-expression, VEGF-A, VEGF-B, TNF, NFKB1
Public URL


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