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Identifying Specific Antigenic Targets of Kawasaki Disease

Award Number: R01AI150719
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/22/2020
PERIOD OF PERFORMANCE END DATE: 08/31/2025

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Identifying Specific Antigenic Targets of Kawasaki Disease - PROJECT SUMMARY/ABSTRACT Kawasaki Disease (KD) is the leading cause of acquired heart disease in children in developed nations. KD can result in coronary artery aneurysms that can lead to lifelong heart disease, myocardial infarction, and death. The clinical and epidemiologic features support an infectious etiology in genetically susceptible children, but the cause has eluded more than 50 years of study. Delayed and missed diagnoses increase the risk of coronary artery aneurysms. The development of urgently needed diagnostic tests and improved therapies are dependent upon identifying the etiology. In preliminary studies, we analyzed the peripheral blood plasmablast response at 1-3 weeks after KD fever onset using single cell RT-PCR and made 60 monoclonal antibodies (Mab) from these plasmablasts. We used these Mab to determine their target antigens. We found that 32/60 Mab, derived from 9/11 KD patients, identify intracytoplasmic virus-like inclusion bodies (ICI) in ciliated bronchial epithelium of KD children but not infant controls. Using peptide arrays to identify binding epitope(s), amino acid substitution arrays, and ELISA, we found that 5 of the 32 (16%) Mab, derived from 3 KD patients with coronary artery aneurysms, recognize KD peptide epitope 1. KD peptide 1 completely blocks binding of these Mab to KD ICI, indicating that a protein with the binding epitope sequence is present in the ICI. Moreover, pre-treatment sera from 5/8 KD patients >day 8 after fever onset but 0/17 infant control sera have IgG antibody to the peptide epitope. We recently identified two additional epitopes using this approach that require further study. These findings support our hypothesis that at least a subset of KD cases results from infection with a presently unidentified, ubiquitous viral causative agent containing the KD peptide epitope 1 sequence. In this proposal, we hypothesize that identification of antigens targeted by the plasmablast response to KD can lead to identification of the etiology(ies) and development of KD serologic tests. To test these hypotheses, we will: 1) identify the specific proteins recognized by our panel of KD Mab that bind to KD tissues, 2) screen for additional antigenic targets recognized by the immune response to KD, and 3) evaluate the antibody responses of KD and control sera to KD antigens. Our findings will inform pathogenesis of KD, with the long-term goals of improving diagnosis and treatment of KD, enabling prevention, and reducing healthcare costs from the long-term consequences of coronary artery aneurysms arising in young childhood.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2024	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Allergy and Infectious Diseases Research	000	5	1/28/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $414,612 )
2024	2024	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Allergy and Infectious Diseases Research	000	5	7/17/2024	NON-COMPETING CONTINUATION	$414,612
														Subtotal = $414,612

Issue Date FY: 2023 ( Subtotal = $427,311 )
2023	2023	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Allergy and Infectious Diseases Research	000	4	7/27/2023	NON-COMPETING CONTINUATION	$427,311
														Subtotal = $427,311

Issue Date FY: 2022 ( Subtotal = $428,841 )
2022	2022	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Allergy and Infectious Diseases Research	000	3	8/18/2022	NON-COMPETING CONTINUATION	$428,841
														Subtotal = $428,841

Issue Date FY: 2021 ( Subtotal = $440,507 )
2021	2021	ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Allergy and Infectious Diseases Research	000	2	7/30/2021	NON-COMPETING CONTINUATION	$440,507
														Subtotal = $440,507

Issue Date FY: 2020 ( Subtotal = $503,599 )
2020	2020	ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Allergy and Infectious Diseases Research	000	1	9/22/2020	NEW	$503,599
														Subtotal = $503,599

Grand Total All Awards = $2,214,870

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Identifying Specific Antigenic Targets of Kawasaki Disease

Award Number: R01AI150719

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/22/2020

PERIOD OF PERFORMANCE END DATE: 08/31/2025

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