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Differential protein analysis of serum exosomes post-intravenous immunoglobulin therapy in patients with Kawasaki disease

  • Li Zhang (a1), Qi-Fang Song (a2), Jing-Jie Jin (a3), Ping Huang (a1), Zhou-Ping Wang (a1), Xiao-Fei Xie (a1), Xiao-Qiong Gu (a1), Xue-Juan Gao (a3) and Hong-Ling Jia (a3)...



Kawasaki disease, which is characterised by systemic vasculitides accompanied by acute fever, is regularly treated by intravenous immunoglobulin to avoid lesion formation in the coronary artery; however, the mechanism of intravenous immunoglobulin therapy is unclear. Hence, we aimed to analyse the global expression profile of serum exosomal proteins before and after administering intravenous immunoglobulin.


Two-dimensional electrophoresis coupled with mass spectrometry analysis was used to identify the differentially expressed proteome of serum exosomes in patients with Kawasaki disease before and after intravenous immunoglobulin therapy.


Our analysis revealed 69 differential protein spots in the Kawasaki disease group with changes larger than 1.5-fold and 59 differential ones in patients after intravenous immunoglobulin therapy compared with the control group. Gene ontology analysis revealed that the acute-phase response disappeared, the functions of the complement system and innate immune response were enhanced, and the antibacterial humoral response pathway of corticosteroids and cardioprotection emerged after administration of intravenous immunoglobulin. Further, we showed that complement C3 and apolipoprotein A-IV levels increased before and decreased after intravenous immunoglobulin therapy and that the insulin-like growth factor-binding protein complex acid labile subunit displayed reverse alteration before and after intravenous immunoglobulin therapy. These observations might be potential indicators of intravenous immunoglobulin function.


Our results show the differential proteomic profile of serum exosomes of patients with Kawasaki disease before and after intravenous immunoglobulin therapy, such as complement C3, apolipoprotein A-IV, and insulin-like growth factor-binding protein complex acid labile subunit. These results may be useful in the identification of markers for monitoring intravenous immunoglobulin therapy in patients with Kawasaki disease.


Corresponding author

#Correspondence to: X.-J. Gao and H.-L. Jia, Key Laboratory of Functional Protein Research of Guangdong Higher Education Institutes, Institute of Life and Health Engineering, College of Life Science and Technology, Jinan University, 601 Huangpu Ave W, The 2nd Science and Technology Building, Room 914, Guangzhou 510632, China. Tel: +86 208 522 1071; Fax: +86 208 522 1071; E-mail:;


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Li Zhang, Qi-Fang Song, and Jing-Jie Jin contributed equally to this work.



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