{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:26:28Z","timestamp":1787840788505,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":238,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kawasaki disease is an acute systemic vasculitis, and the clinical significance of serum thymus and activation\u2010regulated chemokine (TARC) remains incompletely understood. We examined whether pre\u2010treatment age\u2010adjusted serum TARC was associated with inflammation\u2010based intravenous immunoglobulin (IVIG) resistance risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied 109 children with Kawasaki disease after excluding documented allergic comorbidities and age younger than 6\u2009months. All included patients had serum TARC measured before initial treatment, and 18 of them also had paired post\u2010treatment measurements. Serum values were expressed as the percentage of the age\u2010specific upper limit of normal. The primary analysis compared pre\u2010treatment values between high\u2010 and low\u2010risk groups according to the Kobayashi score. Paired pre\u2010 and post\u2010treatment changes and exploratory analyses of other IVIG resistance risk scores and treatment non\u2010response were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty children were classified as high risk by the Kobayashi score. Pre\u2010treatment age\u2010adjusted values were lower in the high\u2010risk group than in the low\u2010risk group, but logistic regression analysis did not support a statistically robust association. In 18 children with paired samples, values decreased significantly after treatment. Exploratory analyses showed no significant associations with other IVIG resistance risk scores, whereas analyses of treatment non\u2010response and coronary artery lesions were limited by the small number of events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Age\u2010adjusted serum TARC showed limited clinical associations during the acute phase of Kawasaki disease and was not robustly associated with inflammation\u2010based high\u2010risk classification. Its role in treatment response and coronary artery outcomes remains to be clarified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70527","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:28:59Z","timestamp":1787837339000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Limited Clinical Associations of Age\u2010Adjusted Serum Thymus and Activation\u2010Regulated Chemokine in Kawasaki Disease"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-8327","authenticated-orcid":false,"given":"Shinya","family":"Tomori","sequence":"first","affiliation":[{"name":"Department of Pediatrics Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4729-8639","authenticated-orcid":false,"given":"Kazuhiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-2496","authenticated-orcid":false,"given":"Masakazu","family":"Mimaki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"178","article-title":"Acute Febrile Mucocutaneous Lymph Node Syndrome: Clinical Observation of 50 Cases","volume":"16","author":"Kawasaki T.","year":"1967","journal-title":"Arerug\u012b"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1146\/annurev-med-050224-103456","article-title":"Kawasaki Disease Vasculitis: From Diagnosis to New Concepts in Pathophysiology and Therapeutic Approaches","volume":"77","author":"Noval Rivas M.","year":"2026","journal-title":"Annual Review of Medicine"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2025.1582638","article-title":"Kawasaki Disease: Insights Into the Roles of T Cells","volume":"16","author":"Wang S.","year":"2025","journal-title":"Frontiers in Immunology"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/intimm\/11.1.81","article-title":"Selective Recruitment of CCR4\u2010Bearing Th2 Cells Toward Antigen\u2010Presenting Cells by the CC Chemokines Thymus and Activation\u2010Regulated Chemokine and Macrophage\u2010Derived Chemokine","volume":"11","author":"Imai T.","year":"1999","journal-title":"International Immunology"},{"key":"e_1_2_10_6_1","first-page":"544","article-title":"TARC\/CCL17 Gene Polymorphisms and Expression Associated With Susceptibility and Coronary Artery Aneurysm Formation in Kawasaki Disease","volume":"74","author":"Lee C. P.","year":"2013","journal-title":"Pediatric Research"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12887-015-0424-6","article-title":"Plasma Levels of Monokine Induced by Interferon\u2010\u03b3\/Chemokine (C\u2010X\u2010C Motif) Ligand 9 and Thymus and Activation\u2010Regulated Chemokine\/Chemokine (C\u2010C Motif) Ligand 17 in Children With Kawasaki Disease","volume":"15","author":"Feng S.","year":"2015","journal-title":"BMC Pediatrics"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1161\/CIRCULATIONAHA.105.592865","article-title":"Prediction of Intravenous Immunoglobulin Unresponsiveness in Patients With Kawasaki Disease","volume":"113","author":"Kobayashi T.","year":"2006","journal-title":"Circulation"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jpeds.2006.03.050","article-title":"Prediction of Resistance to Intravenous Immunoglobulin Treatment in Patients With Kawasaki Disease","volume":"149","author":"Egami K.","year":"2006","journal-title":"Journal of Pediatrics"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s00431-006-0223-z","article-title":"Prediction of Non\u2010Responsiveness to Standard High\u2010Dose Gamma\u2010Globulin Therapy in Patients With Acute Kawasaki Disease Before Starting Initial Treatment","volume":"166","author":"Sano T.","year":"2007","journal-title":"European Journal of Pediatrics"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1399-3038.2009.00851.x","article-title":"Serum Measurement of Thymus and Activation\u2010Regulated Chemokine\/CCL17 in Children With Atopic Dermatitis: Elevated Normal Levels in Infancy and Age\u2010Specific Analysis in Atopic Dermatitis","volume":"20","author":"Fujisawa T.","year":"2009","journal-title":"Pediatric Allergy and Immunology"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2500\/aap.2022.43.220034","article-title":"Serum Thymus and Activation\u2010Regulated Chemokine Levels Correlate With Atopic Dermatitis Disease Severity in Patients Younger Than 6 Months","volume":"43","author":"Koizumi M.","year":"2022","journal-title":"Allergy and Asthma Proceedings"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/j.1365-2222.2010.03634.x","article-title":"Elevated Umbilical Cord Serum TARC\/CCL17 Levels Predict the Development of Atopic Dermatitis in Infancy","volume":"41","author":"Miyahara H.","year":"2011","journal-title":"Clinical and Experimental Allergy"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1111\/ped.14326","article-title":"Revision of Diagnostic Guidelines for Kawasaki Disease (6th Revised Edition)","volume":"62","author":"Kobayashi T.","year":"2020","journal-title":"Pediatrics 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