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February 22, 2026Journal of Inflammation Research0 citationsOpen Access

SESN2 as a Novel Diagnostic and Prognostic Biomarker for Kawasaki Disease and Coronary Artery Lesions

CLChang LiuYWYi WeiFJFengchuan Jing

Key Result

Serum SESN2 levels were significantly elevated in pediatric Kawasaki disease patients compared to healthy controls (median 5.17 vs 3.49 ng/mL, P=0.001), and SESN2 predicted coronary artery lesions with AUC 0.684 (P=0.013).

Key Points

  • This research aims to evaluate the potential of SESN2 as a diagnostic and prognostic biomarker for Kawasaki Disease and associated coronary artery lesions.
  • Conducted a single-center prospective study involving 72 KD patients and 38 healthy controls.
  • Quantified serum SESN2 levels using enzyme-linked immunosorbent assay (ELISA).
  • Stratified participants according to the presence and severity of coronary artery lesions.
  • Assessed correlations with clinical parameters and inflammatory markers, as well as performing ROC analysis.
  • Serum SESN2 levels were significantly elevated in KD patients compared to healthy controls with P=0.001.
  • Higher SESN2 levels were found in the KD-CAL subgroup, indicating a direct correlation with lesion severity (P=0.014).
  • SESN2 levels positively correlated with inflammatory markers and presented a substantial decrease post-IVIG therapy (P=0.012).
  • ROC analysis demonstrated SESN2's reliability as a diagnostic marker for KD (AUC=0.697) and a predictive marker for CAL (AUC=0.684).

Study Design

Type

Observational (n=110)

Multicenter

No

Structured PICO

Does serum SESN2 level accurately diagnose Kawasaki Disease and predict the development of coronary artery lesions in pediatric patients?

P
Population
110 pediatric subjects, including 72 patients with Kawasaki Disease (median age 30 months, 47.2% male) and 38 age- and sex-matched healthy controls (median age 35 months, 52.8% male). The KD cohort was stratified into subgroups with coronary artery lesions (KD-CAL, n=23) and without coronary artery lesions (KD-NCAL, n=49).
I
Intervention
Measurement of serum Sestrin2 (SESN2) levels using enzyme-linked immunosorbent assay (ELISA)
C
Comparator
Healthy controls (for KD diagnosis) and KD patients without coronary artery lesions (KD-NCAL) (for CAL prediction)
O
Outcome
Diagnostic accuracy of SESN2 for Kawasaki Disease and predictive accuracy for coronary artery lesions (CAL), measured by Area Under the Receiver Operating Characteristic Curve (AUC)surrogate

Main Result

Effect estimate: AUC 0.697 for KD diagnosis; AUC 0.684 for CAL prediction (95% CI KD diagnosis 0.590–0.805; CAL prediction 0.555–0.813)

Absolute Event Rate: 5.17% vs 3.49%

p-value: p=0.001 for KD diagnosis; 0.013 for CAL prediction

Limitations

  • Single-center observational study with relatively small sample size limiting generalizability
  • No febrile control group to assess SESN2 specificity versus other febrile illnesses
  • Modest diagnostic utility of SESN2 alone suggesting need for multi-marker models
  • Incomplete laboratory data for some parameters limiting further validation

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. Keywords: Kawasaki disease, Sestrin2, coronary arterial lesions

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Cite This Study

Liu et al. (2026) conducted an observational in Pediatric patients with Kawasaki disease (median age 30 months) including subgroups with coronary artery lesions (CAL) and non-CAL, vs age- and sex-matched healthy controls (n=110). Serum SESN2 level measurement by ELISA vs. Healthy controls or KD patients without CAL was evaluated on Serum SESN2 level as biomarker for diagnosis of Kawasaki Disease and prediction of coronary artery lesions (CAL) (AUC 0.697 for KD diagnosis; AUC 0.684 for CAL prediction, 95% CI KD diagnosis 0.590–0.805; CAL prediction 0.555–0.813, p=0.001 for KD diagnosis; 0.013 for CAL prediction). Serum SESN2 levels were significantly elevated in pediatric Kawasaki disease patients compared to healthy controls (median 5.17 vs 3.49 ng/mL, P=0.001), and SESN2 predicted coronary artery lesions with AUC 0.684 (P=0.013).

synapsesocial.com/papers/699a9d3c482488d673cd3055https://doi.org/10.2147/jir.s564605
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