{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T07:08:51Z","timestamp":1771830531097,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coronary artery lesions (CALs) in Kawasaki disease (KD) are thought to arise from aberrant immune activation and an amplified inflammatory cascade triggered by an unidentified etiologic factor. Interleukin-23 (IL-23)\u2014a pivotal modulator of chronic inflammatory responses and immune-mediated vascular damage\u2014has lately garnered interest regarding its putative role in cardiovascular pathological processes<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the correlation between circulating IL-23 concentrations and the occurrence of CALs in pediatric patients with KD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Peripheral blood samples were obtained from 103 pediatric patients with KD prior to administration of intravenous immunoglobulin. Using Enzyme-Linked Immunosorbent Assay (ELISA), we quantified circulating cytokine levels in a total of 211 study participants, who were stratified into four distinct cohorts: 47 KD cases with coronary artery lesions, 56 cases without vascular involvement, 58 febrile controls, and 50 healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Serum IL-23 concentrations were markedly elevated in children with KD [279.69\u2005pg\/mL (132.67\u2013693.32)] compared with both febrile controls [161.02\u2005pg\/mL (81.50\u2013338.60)] and healthy controls [132.41\u2005pg\/mL (61.74\u2013274.28)] (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), indicating a disease-specific elevation. Among KD patients, 47 (45.63%) developed CALs. The KD individuals presenting with CAL (KD-CALs) group exhibited markedly higher IL-23 levels [395.76\u2005pg\/mL (221.62\u20131,217.19)] compared with KD individuals without CAL (KD-NCALs) [222.81\u2005pg\/mL (100.18\u2013388.58),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001], accompanied by higher Erythrocyte Sedimentation Rate (ESR) and increased Interleukin-6 (IL-6), matrix metalloproteinase-1 (MMP-1), vascular endothelial growth factor (VEGF) levels. IL-23 displayed significant positive associations with multiple inflammatory indices, including white blood cell count (WBC), C-reactive protein (CRP), IL-6, Interleukin-10 (IL-10), Interleukin-17A (IL-17A), MMP-1, and VEGF. Receiver operating characteristic (ROC) analysis showed that IL-23 effectively discriminated KD from controls [area under the curve (AUC)\u2009=\u20090.71, cutoff\u2009=\u2009202.3\u2005pg\/mL, sensitivity\u2009=\u200966.0%, specificity\u2009=\u200968.0%] and KD-CAL from KD-nCAL (AUC\u2009=\u20090.69, cutoff\u2009=\u2009661.2\u2005pg\/mL, sensitivity\u2009=\u200942.6%, specificity\u2009=\u200987.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated serum IL-23 is associated with heightened inflammatory activity and the presence of coronary artery lesions in KD, suggesting that IL-23 may contribute to CAL pathogenesis and represent a potential biomarker of vascular involvement.<\/jats:p>\n                  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China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Children\u2019s Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"National Clinical Key Cardiovascular Specialty","place":["Chongqing, China"]},{"name":"Key Laboratory of Children\u2019s Vital Organ Development and Diseases of Chongqing Municipal Health Commission","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qijian","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Children\u2019s Hospital 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