New surface air sampling campaigns in Toyama and Kumamoto

New surface air sampling campaigns in Toyama and Kumamoto

Two members of our research team, Roger Curcoll and Dr. Sílvia Borràs, traveled this June to Japan in order to perform a 10 days air sampling campaign. In collaboration with Dr. Fukiko Ichida and Dr. Keiichi Hirono from Toyama University Hospital, the high-volume air samplers were placed on the rooftop of the hospital. During the visit, they were trained to continue with the air sampling on a weekly basis until the end of the Kawasaki disease winter peak (March 2018).
At the same time, a new collaboration with an environmental scientist from the University of Kumamoto, Dr. Tomoko Kojima, was established. In parallel to Toyama’s sampling, Dr. Kojima is in charge of conducting the same sampling scheme during the same period in Kumamoto. In total, around 250 new samples will be collected.

Stay tuned!

What do we know so far? Review published!

What do we know so far? Review published!

The discussion about diseases of unknown etiology, among others Kawasaki disease, arises multiple questions: Can environmental factors, such as air-transported preformed toxins, be of key relevance to the health outcomes of poorly understood human ailments (e.g., rheumatic diseases such as vasculitides, some inflammatory diseases, or even severe childhood acquired heart diseases)? Can the physical, chemical and biological features of air masses be linked to the emergence of diseases such as Kawasaki disease (KD), Henoch–Schönlein purpura, Takayasu’s aortitis, and ANCA-associated vasculitis? Furthermore, would it be possible to develop early-warning systems based on environmental alerts and to implement these alarms to inform predisposed patients?

A lot of questions, right? Let’s discuss it!

Article Ann. N. Y. Acad. Sci. (2016): “Revisiting the role of environmental and climate factors on the epidemiology of Kawasaki disease”, by Xavier Rodó et al.

ISGlobal and HSJD hospital receive a Daniel Bravo Foundation Research Grant to investigate on Kawasaki disease

ISGlobal and HSJD hospital receive a Daniel Bravo Foundation Research Grant to investigate on Kawasaki disease

Fundació Daniel Bravo

This year the Daniel Bravo Andreu Foundation launched the first call for the Daniel Bravo Projects in paediatric research. The main aim of the call encouraged collaboration between clinical groups (which have direct contact with patients) and basic research groups, focusing on unmet medical needs in children under 16 years old. The call awarded three grants of up to 300,000€ for projects conducted over three years at minimum two different non-profit centres in Catalonia. In this first call, the collaborative research between IC3 (now ISGlobal) and the Hospital Sant Joan de Déu, led by researchers Xavier Rodó and Jordi Anton has been awarded.
The project, titled WINDBIOME, aims to discover the etiological agent of Kawasaki disease, to advance understanding of its epidemiology and to create an early warning system to anticipate periods of increased incidence. Let’s get started!

Study in PNAS remains high in Online Impact after more than 7 months after publication

Study in PNAS remains high in Online Impact after more than 7 months after publication

Our study still remains high in its online altimetric scores many months after its publication. According to the PNAS website, our article lies in the top 5% of all articles ranked by attention. It is reported to make very good compared to articles of the same age (99th percentile). So far Altmetric has tracked 24,829 articles from this journal. They typically receive a lot more attention than average, with a mean score of 15.7 vs the global average of 5.1. Our PNAS Kawasaki article has done particularly well, scoring higher than 99% of its peers. More generally, Altimetric has tracked 2,793,987 articles across all journals so far. Compared to these this article has done particularly well and is in the 99th percentile: it’s in the top 5% of all articles ever tracked by Altimetric.

We see that our study has caught a lot of attention. More to come, stay tuned!

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Article PNAS-USA Number #14-00380 (2014): “Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan” by Xavier Rodó et al.

New aircraft campaign scheduled in Japan in February 2015… if funds arrive

New aircraft campaign scheduled in Japan in February 2015… if funds arrive

A new focused aircraft monitoring campaign is scheduled to take place over NW Japan next February, if IC3 scientists manage to gather the amount of funds needed to cover for the costs of the flights. The objective is to further test whether the Candida hypothesis or the environmental toxin agent, both raised in the latest published results is the relevant potential trigger for Kawasaki disease. The researchers now plan to conduct more flights over NW Japan during the high season for Kawasaki disease, exactly over the research station where new equipment was deployed last summer and where a continuous surface air sampling is taking place at the moment. This way, scientists plan to relate what happens atop with surface samples and eventually with the admission of new patients in nearby Toyama and Kanazawa hospitals (see other pieces in Latest News).

airplane

To further proceed, IC3 launched a fund-raising initiative to gather funds to perform these aircraft monitoring campaigns this year and the next. These samples would enable us to continue our research towards an accurate characterization of the nature of this environmental trigger (see DONATE at this same website, www.kawasaki-disease.com ).

KD doctors at Toyama and Kanazawa Medical hospitals join the Kawasaki Consortium

KD doctors at Toyama and Kanazawa Medical hospitals join the Kawasaki Consortium

IC3 and the Kawasaki Disease consortium have established a new joint collaboration with scientists at both Toyama and Kanazawa Hospitals to advance research onto causes of Kawasaki disease. Medical doctor experts on cardiomyopathies and Kawasaki disease Dr. Fukiko Ichida from the University of Toyama and Dr. Tsuneyuki Nakamura in Kanazawa Medical School have recently added to our research consortium. They will provide data of admitted Kawasaki disease patients in a network of branch hospitals at their prefectures.

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Semi-real-time reporting of KD cases in Toyama and Kanazawa with date of onset of fever will serve to trace what is the evolution of hospital KD admissions concomittant with the atmospheric sampling taking place at Ishikawa. Continuous air sampling equipments were deployed in a research station on the coast near both major cities at Ishikawa (see other news). The ultimate aim of this initiative is to be able to compare the contents of the aerosol samples with fluctuations in KD activity in the region. By using location of primary residence of anonymous sick children data, scientists plan to perform a fine backtracing of the air masses thanks to the use of high-resolution atmospheric simulations with FLEXPART-WRF computer models.

Same study demonstrates the Kawasaki disease agent does not act as an infectious disease

Same study demonstrates the Kawasaki disease agent does not act as an infectious disease

A long time has passed since the first Kawasaki disease patient was identified in Japan by Dr. Tomisaku Kawasaki and yet no agreement on its cause and potential agent/s has consistently emerged. Different theories suggested different epidemiological pathways, ranging from a typical infectious disease to different kinds of exacerbated host responses in susceptible children being exposed to one or more noninfectious environmental triggers. Some consensus existed, however, that whatever the trigger was, it enters through the mucosa of the upper respiratory tract. Therefore, assuming that the KD agent is carried by the wind, cases should occur simultaneously in neighboring towns due to the large scale reach of wind patterns and/or propagate fast through infection. The study effectively showed how in cities belonging to the greater Tokyo area on average separated around 30Km, peak incidences of Kawasaki disease occurred simultaneously, that is the same day or one day apart. The epidemiological study showed maximum coherence in the daily variability of Kawasaki patients in cities like Tokyo, Yokohama, Saitama and Chiba. Applying a mathematical model for infectious diseases further confirmed that not even the fastest infectious agent could display on the basis of secondary cases, such a rapid propagation as the one seen for this disease. Therefore, our study discards the action of an infectious agent having to replicate in the host coursing as an infection, and instead favors as the most likely trigger, the role of an idiosyncratic immune response to an environmental particle or toxin.

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Article PNAS-USA Number #14-00380 (2014): “Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan” by Xavier Rodó et al.

Kawasaki disease has a very short response time to exposure

Kawasaki disease has a very short response time to exposure

Analysis of wind dynamics and fluctuations of Kawasaki disease numbers in the different cities within the Greater Tokyo, as well as results from computer simulations with a Lagrangian particle dispersion model suggest that there is a short incubation time for Kawasaki disease, typically in the range of 6 hours to 2.5 days.

Simulations and analyses were performed from epidemiological records in towns in Japan spanning the whole archipelago, from Sapporo in Hokkaido, to Tokyo and Nagoya in the south and from every single day showing an abnormally high presence of admitted patients in hospitals. Both days within and out of major epidemics were tested, yielding similar results and indicating that the peak in Kawasaki disease cases is rapidly attained after the arrival of the wind during the winter season.

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Article PNAS-USA Number #14-00380(2014): “Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan” by Xavier Rodó et al.

New IC3 study uncovers cause of Kawasaki disease in Japan linked to an environmental trigger contained in winds from agricultural regions in northeast China

New IC3 study uncovers cause of Kawasaki disease in Japan linked to an environmental trigger contained in winds from agricultural regions in northeast China

Kawasaki disease may be caused by fungal particles or toxins carried on wind currents from dense croplands in northeastern China to Japan, according to our new study published in the Proceedings of the National Academy of Sciences of the United States of America. Kawasaki disease, the leading cause of acquired heart disease in children worldwide, inflames coronary arteries of affected young children and may lead to fatal heart disease. The causative agent of this disease, first observed in Japan in the 1960s and that has since then been recognized in other countries in the world, is yet unknown. Noting that the timing of Kawasaki disease outbreaks coincided with certain wind patterns from Asia, Xavier Rodó and colleagues simulated air currents and airborne particle transport in computer models on all days since 1977 and up to 2010, with high numbers of Kawasaki disease cases in Japan and using the vast epidemiologic database compiled by Nakamura and colleagues at Jichi Medical University in Japan. The thousands of model simulations conclusively suggested that the incidence of Kawasaki disease in many locations around Japan, in and out of epidemic years, peaked only when winds originated from a densely-cultivated region in northeastern China, characterized by vast extensions of cereal croplands. An aircraft campaign performed by IC3 scientists over Japan in 2011, in collaboration with Dr. Tanimoto from Tsukuba University and Dr. Brent Williams and Ian Lipkin at Columbia University, successfully isolated several Candida species as the dominant fungus aloft, demonstrating the potential for human disease in aerosols transported by wind currents.

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Article PNAS-USA Number #14-00380 (2014): “Tropospheric winds from northeastern China carry the etiologic agent of Kawasaki disease from its source to Japan” by Xavier Rodó et al.

IC3 and Hospital Sant Joan de Déu in Barcelona launch a collaborative study to analyze Kawasaki cases in Catalunya

IC3 and Hospital Sant Joan de Déu in Barcelona launch a collaborative study to analyze Kawasaki cases in Catalunya

Scientists of IC3 and Hospital Sant Joan de Déu in Barcelona have recently joined forces in the search of an etiological agent and potential treatment for Kawasaki disease patients. The Hospital’s group led by Dr. Jordi Anton, Senior Attendant of the Pediatric Rheumatology Unit has an special interest in this disease and follows a big cohort of patients, leading a collaborative registry effort of all the pediatric centers in Catalonia and it has been working since long on immunological and molecular aspects related to this disease. The collaboration will enable both the retrospective records and the near-real time study of cases appearing at hospitals in Catalunya, and the analysis of related air masses and their source regions. This study will cover from the characterization of atmospheric samples to the study of determinant chemical and biological traits in blood aliquots from Kawasaki patients.

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