Dr. Kentaro Omoya

Abstract:

Kawasaki disease (KD) is an acute systemic vasculitis of unknown etiology that primarily affects infants and young children. In Japan, it represents the leading cause of acquired heart disease in children. The most serious complication is the development of coronary artery lesions (CAL), which are directly associated with long-term cardiovascular risk. Although immune dysregulation, genetic predisposition, and infectious triggers have been implicated in the pathogenesis of KD, increasing attention has been directed toward the involvement of oxidative stress (OS). 

During the acute phase of KD, OS caused by excessive production of reactive oxygen species (ROS) and impaired antioxidant defense mechanisms contributes to vascular inflammation through endothelial cell injury, enhanced cytokine production, and platelet dysfunction. High OS levels in the early phase have been associated with an increased risk of CAL, and OS biomarkers may serve as potential predictors of disease severity. Moreover, OS may persist into the subacute and chronic phases, even after the resolution of overt inflammation. This ongoing oxidative imbalance may impair vascular recovery and contribute to long-term vascular dysfunction, possibly accelerating the development of atherosclerosis. In recent years, the clinical application of OS-related biomarkers has emerged, offering new opportunities for mechanistic disease assessment and the development of personalized treatment strategies.

This presentation summarized current evidence regarding the role of OS in the pathophysiology of KD, and explores how OS-based evaluation and therapeutic approaches may enhance clinical care and prognosis in pediatric patients.