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Background Kawasaki Disease (KD), which is mainly characterized by systemic small and medium vasculitis in children, can lead to coronary artery lesions (CALs). Our previous study identified that STAT3 signaling plays essential roles during the acute phase of KD patients. However, whether its interacted protein MDM2 (Murine double minute 2), which functions as an E3 ligase is likewise involved in KD pathogenesis still unknown and remains to be investigated. Methods The role of MDM2 was investigated using the whole-blood samples from KD patients with CALs before and after IVIG treatment. The plasma and peripheral blood mononuclear cells were respectively isolated and collected. Meanwhile, a Candida albicans cell wall extracts (CAWS)‑induced KD mouse model was used to analyze the in vivo functions of MDM2. Real-time PCR, western blotting, and enzyme-linked immunosorbent methods were used respectively in the HCAECs or other cells to investigate the molecular mechanism of MDM2 involved in KD. Results MDM2 levels were downregulated, and STAT3 and VEGFA levels were upregulated in clinical blood samples from KD patients with CAL in the acute stage and in the mouse model. In the mouse model and HCAECs, MDM2 co-located with STAT3 . In vitro, the endogenous STAT3 protein level in HCAECs was upregulated after MDM2knockdown. Overexpression of MDM2 increased STAT3 ubiquitination and endogenous STAT3 and VEGFA levels decreased significantly. Additionally, the E3 ubiquitin ligase MDM2 can target its endogenous substrate STAT3 for ubiquitination. Conclusions Decreased MDM2 levels can reduce STAT3 ubiquitination, leading to STAT3 activation and the induction of VEGFA transcription, which is involved in the vascular endothelial inflammatory injury process of KD.

The spontaneous closure rate of patent ductus arteriosus (PDA) is high, and the necessity of early intervention is debated. Quantitative echocardiographic assessment of the intima in PDA has not been reported. This study evaluated intimal thickness growth in neonatal cases of PDA via echocardiography and investigated its correlation with clinical factors. Seventy-three neonates were enrolled, and echocardiography was performed three times: within 24 h post-birth (first echo), 48 h after the first echo (second echo), and before discharge (third echo). According to PDA outcome, the neonates were divided into the PDA-open group (n = 18 cases), PDA-closure at second echo group (n = 32 cases), and non-PDA at first echo group (n = 23 cases). We measured the intimal thickness (IT1 and IT2 at first and second echo, respectively), lumen diameter of ductus arteriosus (D1 and D2 at first and second echo, respectively), IT1/D1 ratio, and intimal thickness growth rate (V). Correlations between echocardiographic indicators, perinatal factors, and clinical treatment were analyzed. On first echo, the PDA-open group showed a significantly lower IT1/D1 than the combined PDA-closure group (P

The present study used microarray analysis to screen the plasma expression of microRNAs (miRNAs) in patients with acute Kawasaki disease (KD) and aimed to explore the pathogenesis of KD. Plasma was collected from children with acute KD (n=6) and from healthy control children (n=6). Total RNA was extracted and differential miRNA expression between the two groups was determined. Differentially expressed miRNAs were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) in an independent cohort (n=8). Target genes of the differentially expressed miRNAs were predicted and analyzed for gene ontology term enrichment and Kyoto Encyclopedia of Genes and Genomes pathways. miRNA microarray analysis revealed that seven miRNAs (miRs) were significantly upregulated (hsa-let-7b-5p, hsa-miR-223-3p, hsa-miR-4485, hsa-miR-4644, hsa-miR-4800-5p, hsa-miR-6510-5p and hsa-miR-765) and three were significantly downregulated (hsa-miR-33b-3p, hsa-miR-4443 and hsa-miR-4515) in acute KD compared with the healthy controls. hsa-miR-223-3p expression levels detected by RT-qPCR were consistent with the microarray results. A total of 62 target genes of hsa-miR-223-3p were predicted. In total, 10 differentially expressed miRNAs were identified in acute KD, of which hsa-miR-223-3p was verified by RT-qPCR.