Kawasaki disease and soy: potential role for isoflavone interaction with Fcγ receptors.

Kawasaki disease (KD) is a diffuse vasculitis occurring in children and showing predilection for the coronary arteries. The etiology remains unknown, although some risk factors for susceptibility have been defined. Asian ethnicity is a primary risk factor. Several theories have circulated regarding the differences in KD ethnic incidence. Those theories implicating genetic differences among populations as the cause for this discrepancy have dominated and are areas of active investigation by multiple research groups. Differences in diet between Asians and Westerners are touted as reasons for certain ethnic-related discrepancies in susceptibility to cardiovascular disease and cancer in adults. Surprisingly, these cultural dietary differences have not been previously considered as the source of the discrepancy in KD incidence among these ethnic populations. Recent data from genetic studies have highlighted the role of specific immune receptors in the pathogenesis of KD. Functions of the Fcγ receptors (FcGRs) are modulated by isoflavones in soy, in particular, genistein. Epidemiological data from Hawaiian populations support an association between soy consumption and KD. These observations form the basis of a hypothesis: isoflavones participate in KD pathogenesis by modulating function of the FcGRs and by disrupting the balance between activation and inhibition of the inflammatory response.