Abstract
BACKGROUND: Kawasaki Disease (KD), a leading cause of acquired heart disease in children, presents significant diagnostic and prognostic challenges due to its complex pathogenesis and lack of specific biomarkers, leading to potential delays in treatment and increased risk of coronary artery lesions (CALs). Sestrin2 (SESN2), a stress-inducible protein with documented cytoprotective functions and established biomarker utility in cardiovascular diseases, warrants investigation in KD. METHODS: We conducted a single-center prospective study enrolling 72 KD patients and 38 healthy controls (HCs). Serum SESN2 levels were quantified using enzyme-linked immunosorbent assay (ELISA). Participants were stratified by CAL presence and severity. We evaluated SESN2 levels in different groups, assessed its correlations with clinical parameters and inflammatory markers, and performed ROC analysis to determine its diagnostic and predictive accuracy for KD and CAL. RESULTS: Serum SESN2 levels were significantly elevated in KD patients compared to HCs (P=0.001), with markedly higher levels in the KD-CAL subgroup (P=0.014), escalating stepwise with lesion severity. SESN2 positively correlated with inflammatory markers and coronary artery lesions. A substantial reduction in SESN2 was observed post-IVIG therapy (P=0.012). ROC analysis revealed SESN2 as a reliable diagnostic marker for KD (AUC=0.697) and a predictive marker for CAL (AUC=0.684). CONCLUSION: Serum SESN2 is a valuable biomarker for KD, capable of reflecting disease activity and predicting CAL. This dual function highlights its potential to improve risk stratification and guide clinical management in affected children.