Tomisaku Kawasaki

Bio: Tomisaku Kawasaki is an academic researcher from University of Tokyo. The author has contributed to research in topics: Kawasaki disease & Incidence (epidemiology). The author has an hindex of 29, co-authored 54 publications receiving 2940 citations.

ITPKC functional polymorphism associated with Kawasaki disease susceptibility and formation of coronary artery aneurysms.

Abstract: Kawasaki disease is a pediatric systemic vasculitis of unknown etiology for which a genetic influence is suspected We identified a functional SNP (itpkc_3) in the inositol 1,4,5-trisphosphate 3-kinase C (ITPKC) gene on chromosome 19q132 that is significantly associated with Kawasaki disease susceptibility and also with an increased risk of coronary artery lesions in both Japanese and US children Transfection experiments showed that the C allele of itpkc_3 reduces splicing efficiency of the ITPKC mRNA ITPKC acts as a negative regulator of T-cell activation through the Ca2+/NFAT signaling pathway, and the C allele may contribute to immune hyper-reactivity in Kawasaki disease This finding provides new insights into the mechanisms of immune activation in Kawasaki disease and emphasizes the importance of activated T cells in the pathogenesis of this vasculitis

Kawasaki disease in families.

Abstract: The rate of second-case Kawasaki disease occurring among 1788 siblings of children with the disease was derived from data obtained from questionnaires mailed to the members of the Japanese Association of Parents of Children With Kawasaki Disease Within 1 year after the onset of the first case in a family, the overall second-case rate was 21% for siblings, as compared to an overall incidence of approximately 019% in the general population of children 0 to 4 years of age in Japan in the epidemic year 1982 For siblings younger than 1 year of age, it was 84%, and for those between 1 and 2 years of age, it was 93% More than half (541%) of the second cases developed 10 days or less after the first cases occurred

Incidence Survey of Kawasaki Disease in 1997 and 1998 in Japan

Abstract: Objective. To describe the results of a nationwide epidemiologic survey of Kawasaki disease for the 2-year period 1997 and 1998. Design. We sent a questionnaire to all hospitals with 100 beds or more throughout Japan (2663 hospitals) requesting data on patients with Kawasaki disease. Study items included name, sex, date of birth, date of initial hospital visit, diagnosis, address, recurrence, sibling cases, gammaglobulin treatment, and cardiac lesion in the acute stage or 1 month after onset. Results. Of the 2663 hospitals, 68.5% responded, reporting 12 966 patients—7489 males and 5477 females. Of the total patients reported, 6373 (incidence rate of 108.0 per 100 000 children Conclusion. The incidence rates have been steadily increasing for 11 years since 1987. The rate in 1998 was over 1.5 times higher than that in 1987. The age and sex distributions were identical in each survey. Although most of the cardiac lesions at the acute stage decreased to half or less 1 month after onset, giant aneurysms did not decrease and existed persistently after 1 month.

Seasonality and temporal clustering of Kawasaki syndrome.

Abstract: Kawasaki syndrome is an acute, self-limited vasculitis of infants and children with unknown etiology. Seasonality of this condition was first reported by Tomisaku Kawasaki in 1967.1 He described an increase in cases in the spring and summer and a decrease in the fall and winter during a 5-year period (1961–1966). An increased incidence of Kawasaki syndrome in the winter-spring months has been reported from many different geographic regions.2-6 This syndrome is recognized by a constellation of clinical signs (including fever, rash, and conjunctival injection) lasting 1 to 2 weeks. An infectious etiology is suspected on the basis of the clinical similarities to other infectious diseases. Peak incidence occurs in the infant/toddler age group, with only rare cases in infants younger than 3 months of age and in adults. This suggests that transplacental antibodies may confer protection and also that most infections are asymptomatic and result in the development of protective antibodies. The major complication of Kawasaki syndrome is damage to the coronary arteries, which can be prevented in most cases with a high dose of intravenous gamma globulin administered within the first 10 days of fever. Kawasaki syndrome is now the leading cause of acquired heart disease in children in the United States and Japan. The rising incidence in Japan and perhaps the United Kingdom lends a sense of urgency to finding the cause.7,8 At current rates, 1 of every 150 children in Japan will suffer from Kawasaki syndrome. Clear documentation of seasonality and clustering of Kawasaki syndrome cases would lend further weight to the hypothesis that Kawasaki syndrome has an environmental trigger.

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association.

Abstract: Background: Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acqui...

Caspase Functions in Cell Death and Disease

Abstract: Caspases are a family of endoproteases that provide critical links in cell regulatory networks controlling inflammation and cell death. The activation of these enzymes is tightly controlled by their production as inactive zymogens that gain catalytic activity following signaling events promoting their aggregation into dimers or macromolecular complexes. Activation of apoptotic caspases results in inactivation or activation of substrates, and the generation of a cascade of signaling events permitting the controlled demolition of cellular components. Activation of inflammatory caspases results in the production of active proinflammatory cytokines and the promotion of innate immune responses to various internal and external insults. Dysregulation of caspases underlies human diseases including cancer and inflammatory disorders, and major efforts to design better therapies for these diseases seek to understand how these enzymes work and how they can be controlled.

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents.

Abstract: Background Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19)...

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

Abstract: Background—Kawasaki disease is an acute self-limited vasculitis of childhood that is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. Coronary artery aneurysms or ectasia develop in 15% to 25% of untreated children and may lead to ischemic heart disease or sudden death. Methods and Results—A multidisciplinary committee of experts was convened to revise the American Heart Association recommendations for diagnosis, treatment, and long-term management of Kawasaki disease. The writing group proposes a new algorithm to aid clinicians in deciding which children with fever for 5 days and 4 classic criteria should undergo echocardiography, receive intravenous gamma globulin (IVIG) treatment, or both for Kawasaki disease. The writing group reviews the available data regarding the initial treatment for children with acute Kawasaki disease, as well for those who have persistent or recrudescent fever despite initial therapy with IVIG, including IVIG retreatment and treatment with corticosteroids, tumor necrosis factor- antagonists, and abciximab. Long-term management of patients with Kawasaki disease is tailored to the degree of coronary involvement; recommendations regarding antiplatelet and anticoagulant therapy, physical activity, follow-up assessment, and the appropriate diagnostic procedures to evaluate cardiac disease are classified according to risk strata. Conclusions—Recommendations for the initial evaluation, treatment in the acute phase, and long-term management of patients with Kawasaki disease are intended to assist physicians in understanding the range of acceptable approaches for caring for patients with Kawasaki disease. The ultimate decisions for case management must be made by physicians in light of the particular conditions presented by individual patients. (Circulation. 2004;110:2747-2771.)

ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina)

Abstract: The Clinical Efficacy Assessment Subcommittee of the American College of Physicians–American Society of Internal Medicine acknowledges the scientific validity of this product as a background paper and as a review that captures the levels of evidence in the management of patients with chronic stable angina as of November 17, 2002 The American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines regularly reviews existing guidelines to determine when an update or a full revision is needed This process gives priority to areas in which major changes in text, and particularly recommendations, are merited on the basis of new understanding or evidence Minor changes in verbiage and references are discouraged The ACC/AHA/American College of Physicians–American Society of Internal Medicine (ACP-ASIM) Guidelines for the Management of Patients With Chronic Stable Angina, which were published in June 1999, have now been updated The full-text guideline incorporating the updated material is available on the Internet (wwwaccorg or wwwamericanheartorg) in both a track-changes version showing the changes in the 1999 guideline in strike-out (deleted text) and highlighting …