Lipidomics links oxidized phosphatidylcholines and coronary arteritis in Kawasaki disease

Yasutaka Nakashima, Yasunari Sakai, Yumi Mizuno, Kenji Furuno, Keiichi Hirono, Shinichi Takatsuki, Hiroyuki Suzuki, Yoshihiro Onouchi, Tohru Kobayashi, Kazuhiro Tanabe, Kenji Hamase, Tomofumi Miyamoto, Ryohei Aoyagi, Makoto Arita, Kenichiro Yamamura, Tamami Tanaka, Hisanori Nishio, Hidetoshi Takada, Shouichi Ohga, Toshiro Hara

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Aims: Coronary arteritis is a life-threatening complication that may arise in the acute stage of Kawasaki disease (KD), the leading cause of systemic vasculitis in childhood. Various microorganisms and molecular pathogens have been reported to cause KD. However, little is known about the key molecules that contribute to the development of coronary arteritis in KD. Methods and results: To identify causative molecules for coronary arteritis in KD, we prospectively recruited 105 patients with KD and 65 disease controls in four different parts of Japan from 2015 to 2018. During this period, we conducted lipidomics analyses of their sera using liquid chromatography-mass spectrometry (LC-MS). The comprehensive LC-MS system detected a total of 27 776 molecules harbouring the unique retention time and m/z values. In the first cohort of 57 KD patients, we found that a fraction of these molecules showed enrichment patterns that varied with the sampling region and season. Among them, 28 molecules were recurrently identified in KD patients but not in controls. The second and third cohorts of 48 more patients with KD revealed that these molecules were correlated with inflammatory markers (leucocyte counts and C-reactive proteins) in the acute stage. Notably, two of these molecules (m/z values: 822.55 and 834.59) were significantly associated with the development of coronary arteritis in the acute stage of KD. Their fragmentation patterns in the tandem MS/MS analysis were consistent with those of oxidized phosphatidylcholines (PCs). Further LC-MS/MS analysis supported the concept that reactive oxygen species caused the non-selective oxidization of PCs in KD patients. In addition, the concentrations of LOX-1 ligand containing apolipoprotein B in the plasma of KD patients were significantly higher than in controls. Conclusion: These data suggest that inflammatory signals activated by oxidized phospholipids are involved in the pathogenesis of coronary arteritis in KD. Because the present study recruited only Japanese patients, further examinations are required to determine whether oxidized PCs might be useful biomarkers for the development of coronary arteritis in broad populations of KD.

Original languageEnglish
Pages (from-to)96-108
Number of pages13
JournalCardiovascular Research
Issue number1
Publication statusPublished - 2021 Jan 1


  • Atherogenic signals
  • Coronary artery lesions
  • Kawasaki disease
  • Lipidomics
  • Mass spectrometry
  • Oxidized phosphatidylcholines

ASJC Scopus subject areas

  • General Medicine


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