The evaluation value of serum AIM2 and PK2 levels in children with Kawasaki disease for coronary artery injury

Tian Xianmin; Wang Sijian; Wang Huan; Li Tingjun; Jiang Xunwei

doi:10.3969/j.issn.1671-6450.2025.02.012

Abstract：Objective To study the serum levels of melanoma deficiency factor 2(AIM2)and prokinetin 2(PK2)in Kawasaki disease(KD)children and their relationship with disease severity and predictive value in coronary artery injury.Methods One hundred and forty-eight KD children diagnosed and treated in the Emergency department/cardiology de-partment of Shanghai Children's Hospital from January 2020 to December 2022 were selected as the KD group,divided into coronary artery injury(CAL)subgroup(41 cases)and non-CAL subgroup(107 cases).According to the severity of CAL condition,18 cases were divided into mild CAL group,13 cases were divided into moderate CAL group;10 cases in the se-vere CAL group.60 healthy children who underwent physical examination at the same time were selected as the healthy control group.Enzyme linked immunosorbent assay was used to detect serum levels of AIM2 and PK2.Logistic regression and receiver operating characteristic curve were conducted to analyze the value of serum AIM2 and PK2 in CAL in children with KD.Results The serum AIM2 level in the KD group was higher than that in the healthy control group,while the ser-um PK2 level was lower than that in the healthy control group(t/P=38274/＜0.001,28.934/＜0.001).Compared with the non-CAL subgroup,the CAL subgroup had higher fever time,C-reactive protein,and serum AIM2,while the serum PK2 was lower(t/P=6.774/＜0.001,17 365/＜0.001,26.703/＜0.001,19.502/＜0.001).The serum AIM2 of KD group children was posi-tively correlated with fever time and C-reactive protein(r=0.689,0.713,all P＜0.001);Serum PK2 was negatively correlated with fever time and C-reactive protein(r=-0.762,-0.689,all P＜0.001).The serum AIM2 levels in the mild CAL group,moderate CAL group,and severe CAL group increased sequentially,while the serum PK2 levels decreased sequentially(F/P=158.710/＜0.001,60.081/＜0.001).Long fever duration,high C-reactive protein,and high serum AIM2 were independent risk factors affecting the occurrence of CAL in children with KD,while serum PK2 was a protective factor[OR(95％CI)=1.387(1.124-1.710),1.573(1241-1.994),1.338(1.057-1.692),0.773(0.619-0.964)].The area under the curve of serum AIM2 and PK2 combined prediction for the occurrence of CAL in KD children was 0.928(0.884-0.958),which was larger than that of serum AIM2.PK2 single detection was 0.852(0.819-0.887)and 0.858(0.811-0.892)(Z/P=4.616/＜0.001,4.602/＜0.001).Conclusion The increase of serum AIM2 and decrease ofPK2 patients are related with disease severity in KD.The combination of serum AIM2 and PK2 has a high evaluation value for the occurrence of CAL in KD patients.