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Background  Kawasaki disease (KD) is an acute, self-limited febrile illness of unknown cause. And it predominantly affects children &amp;lt;5 years and the main complication is coronary artery lesion (CAL). Studies demonstrated that vascular endothelial cells (VECs) played a very important role in the CAL of KD. VE-cad encoded by  CDH5  may exert a relevant role in endothelial cell biology through controlling the cohesion of the intercellular junctions. The pathogenesis of KD remains unclear and genetic factors may increase susceptibility of KD. However, the relationship between  CDH5  polymorphisms and KD susceptibility has not been reported before. The present study is aimed at investigating whether the rs7404339 polymorphism in  CDH5  is associated with KD susceptibility and CAL in a southern Chinese child population.    Methods and Results  We recruited 1,335 patients with KD and 1,669 healthy children. Each participant had supplied 2 mL of fresh blood in the clinical biologic bank at our hospital for other studies. Multiplex PCR is used to assess the genotypes of rs7404339 polymorphism in  CDH5 . According to the results, we found significant correlated relationship between rs7404339 polymorphism in  CDH5  and KD susceptibility [AA vs. GG: adjusted odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.00–2.05;  p  = 0.0493; recessive model: adjusted  OR  = 1.44, 95%  CI  = 1.01–2.06,  P  = 0.0431]. In further stratified analysis, we found that children younger than 60 months (adjusted  OR  = 1.46, 95%  CI  = 1.01–2.10;  p  = 0.0424) and male (adjusted  OR  = 1.70, 95%  CI  = 1.09–2.65;  p  = 0.0203) with the rs7404339 AA genotype in  CDH5  had a higher risk of KD than carriers of the GA/GG genotype. Furthermore, stratification analysis revealed that patients with the rs7404339 AA genotype exhibited the significantly higher onset risk for CAL than carriers of the GA/GG genotype (adjusted age and gender odds ratio = 1.56, 95%  CI  = 1.01–2.41;  P  = 0.0433).    Conclusion  Our results showed that rs7404339 AA genotype in  CDH5  is significant associated with KD susceptibility. And children younger than 60 months and male with the rs7404339 AA genotype had a higher risk of KD than carriers with the GA/GG genotype. Furthermore, patients with the rs7404339 AA genotype exhibited a significantly higher risk of CAL complication than carriers of the GA/GG genotype.

frontiers in cardiovascular medicine

The rs7404339 AA Genotype in CDH5 Contributes to Increased Risks of Kawasaki Disease and Coronary Artery Lesions in a Southern Chinese Child Population