Objective: To detect the expression of kininogen1 (KNG1) and arginase-1 (Arg-1) in peripheral blood of children with acute Kawasaki disease (KD)

and to explore the clinical significance. Methods: A total of 117 children diagnosed with KD from Shenzhen Children’s Hospital from Dec. 1st

2020 to Dec. 30th

2022 were selected for the study. Children with KD were divided into the coronary artery lesion (CAL) group (n=53) and non-coronary artery lesion (NCAL) group (n=64) depending on CAL. Levels of KNG1 and Arg-1 in peripheral blood of children with acute KD were detected by enzyme-linked immunosorbent assay (ELISA). Binary Logistic regression analysis and receiver operating characteristic (ROC) curve were used to analyze the risk factors of CAL and predictive value of KNG1 and Arg-1 in children with acute KD. Results: The contents of KNG1 and Arg-1 in CAL group were higher than those in NCAL group (Z/t=-7.25

-6.718

P<0.01). Multivariate Logistic regression analysis showed that KNG1

Arg-1 and proportion of neutrophils (N%) were independent risk factors for KD complicated with CAL. ROC analysis showed that the best predictive value of KNG1 for CAL was 1.536 ng/mL

the area under the curve (AUC) was 0.823 (95%CI from 0.750 to 0.896). Arg-1 ≥7.028 ng/mL could be used to predict the occurrence of CAL

the AUC was 0.862 (95%CI from 0.792 to 0.931). The best predictive value of N% for KD complicated with CAL was 54.7%

and the AUC was 0.610 (95%CI from 0.507 to 0.712). In addition

compared with single indicators

KNG1 combined with Arg-1 and N% had the greatest predictive value for CAL in children with acute KD (AUC=0.929

95%CI from 0.881 to 0.977)

and the sensitivity and specificity were 84.9% and 92.2%

respectively. Conclusion: High expression of KNG1 and Arg-1 in peripheral blood of children with acute KD are independent risk factors for CAL

which may be involved in the occurrence and development of KD complicated with CAL.