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Wang Z, Zhang J, Dong L. Is there any association between asthma and Kawasaki disease? A systematic review and meta-analysis. Pediatr Pulmonol 2021; 56:2503-2511. [PMID: 33983684 DOI: 10.1002/ppul.25443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Shared immune factors are involved in the pathogenesis of asthma and Kawasaki disease (KD). Consequently, several observational studies have explored an association between KD and asthma. This systematic review and meta-analysis aimed to explore the association between KD and asthma. METHODS PubMed and Embase databases were searched for cross-sectional, case-control and cohort studies that investigated the association between KD and asthma. The first author, publication year, study type, sample size, and participant demographics were retrieved. The association between KD and asthma was expressed by the odds ratio (OR) and 95% confidence interval (CI). RESULTS Eleven studies were eligible in the systematic review. The crude ORs (cORs) were extracted from 11 studies, and seven of them also provided adjusted ORs (aORs). The cORs between KD and asthma was 1.53 (95% CI, 1.29-1.81). After adjustment for some confounding factors (age, sex, region), asthma also had an association with KD (aOR, 1.08; 95% CI, 1.00-1.17). The subgroup analyses showed the study design and study location to influence between-study heterogeneity. Analyses of aOR values revealed that asthma onset before KD onset does not appear to increase KD prevalence, whereas people suffering from KD could increase the prevalence of developing asthma. CONCLUSION Our meta-analysis suggested a possible association between preceding KD and asthma onset, but care must be taken when interpreting this result. Prospective cohort studies are needed to assess a causal relationship between these two diseases.
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Affiliation(s)
- Zihan Wang
- Department of Respiratory, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Respiratory, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Shandong University, Jinan, China
| | - Jintao Zhang
- Department of Respiratory, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Respiratory, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Shandong University, Jinan, China
| | - Liang Dong
- Department of Respiratory, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Shandong University, Jinan, China
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Lee SB, Kim YH, Hyun MC, Kim YH, Kim HS, Lee YH. T-Helper Cytokine Profiles in Patients with Kawasaki Disease. Korean Circ J 2015; 45:516-21. [PMID: 26617655 PMCID: PMC4661368 DOI: 10.4070/kcj.2015.45.6.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/11/2015] [Accepted: 06/02/2015] [Indexed: 01/15/2023] Open
Abstract
Background and Objectives Kawasaki disease is an acute systemic vasculitis of which pathogenesis suspected is caused by immune dysregulation. The goal of this study is to evaluate the activation pattern of T helper cell type 1 (Th1) and T helper cell type 2 (Th2) in patients with Kawasaki disease. Subjects and Methods Prospective study of 60 patients (male 36, female 24) with diagnosis of Kawasaki disease were enrolled. One hundred and eighty blood samples from these patients were collected according to the different clinical stages {before initial intravenous immunoglobulin (IVIG), 5 days after initial IVIG, 2 months after initial IVIG}. The plasma level of Th1 cytokines; interferon-gamma (IFN-γ) & interleukin (IL)-2 and Th2 cytokines; IL-4 & IL-10 were measured by enzyme-liked immunosorbent assay. Results In all patients, the plasma level of Th1 cytokines (IFN-γ, IL-2) and Th2 cytokines (IL-4 and IL-10) were markedly elevated during the acute stage of Kawasaki disease. Since then, the plasma level of all these cytokines decreased significantly along with the process of clinical stages. Regardless of the existence of coronary artery lesion or no response to initial IVIG treatment, there were no significant differences between them. Conclusion These data suggest that both Th1 and Th2 cells may be activated simultaneously during the acute stage of Kawasaki disease. Further studies are therefore required to establish the difference of activation pattern of T helper cells between Kawasaki disease and other inflammatory diseases.
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Affiliation(s)
- Sang Bum Lee
- Department of Pediatrics, Kyungbook National University School of Medicine, Daegu, Korea
| | - Young Hyun Kim
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Myung Chul Hyun
- Department of Pediatrics, Kyungbook National University School of Medicine, Daegu, Korea
| | - Yeo Hyang Kim
- Department of Pediatrics, Kyungbook National University School of Medicine, Daegu, Korea
| | - Hee Sun Kim
- Department of Microbiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Young Hwan Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
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Wei CC, Lin CL, Kao CH, Liao YH, Shen TC, Tsai JD, Chang YJ, Li TC. Increased risk of Kawasaki disease in children with common allergic diseases. Ann Epidemiol 2014; 24:340-3. [PMID: 24613197 DOI: 10.1016/j.annepidem.2014.02.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 01/29/2014] [Accepted: 02/07/2014] [Indexed: 12/31/2022]
Abstract
PURPOSE Growing evidence reveals a link between Kawasaki disease (KD) and allergic diseases. This population-based case-control study is to investigate the onset of allergic diseases in children and the associated risks of KD. METHODS From 1996 to 2008, 2748 children with KD and 10,656 randomly selected controls were enrolled. Odds ratios of KD were calculated for the association with pre-existing allergic diseases. RESULTS The children with a single allergic disease had an increased risk of KD, with adjusted odds ratios of having KD of 1.82 for urticaria (95% confidence interval [CI], 1.54-2.14), 1.44 for allergic rhinitis (95% CI, 1.23-1.70), and 1.22 for atopic dermatitis (95% CI, 1.06-1.39). The adjusted odds ratios increased with the number of concurrent allergic diseases, from 1.61 (95% CI, 1.43-1.82) for those with only one allergic disease to 1.71 (95% CI, 1.48-1.98) for those with at least two allergic diseases. The children who made two or more medical visits for associated allergic diseases per year had an increased risk of KD. CONCLUSIONS Children with onset of allergic diseases were at increased risk for KD, and the increased risk was associated with the cumulative effect of concurrent allergic diseases and frequency of seeking medical care.
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Affiliation(s)
- Chang-Ching Wei
- Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan; Department of Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - Yen-Hsiu Liao
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Shen
- Department of Pediatrics, College of Medicine, China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jeng-Dau Tsai
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yen-Jung Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
| | - Tsai-Chung Li
- Department of Public Health, China Medical University, Taichung, Taiwan
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Kuo HC, Chang WC, Yang KD, Yu HR, Wang CL, Ho SC, Yang CY. Kawasaki disease and subsequent risk of allergic diseases: a population-based matched cohort study. BMC Pediatr 2013; 13:38. [PMID: 23522327 PMCID: PMC3614461 DOI: 10.1186/1471-2431-13-38] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 03/19/2013] [Indexed: 12/18/2022] Open
Abstract
Background The risk of allergic diseases among Kawasaki disease (KD) patients relative to the general population is not known. The aim of this study was to perform a population-based cohort study to investigate the risk of allergic diseases among children after KD in Taiwan- a country with the third highest incidence of KD in the world. Methods Data were obtained from the Taiwan National Health Insurance Research Database. In total, 253 patients who were 5 years of age or younger and had a first-time hospitalization with a diagnosis of KD between 1997 and 2005 were included as the study cohort and 1,012 non-KD patients matched for age and sex were included as comparison cohort. Multivariate Cox proportional hazard regression model was used to adjust for confounding and to compare the 6-year allergic-free survival rate between these two cohorts. Results The incidence rate of allergic diseases (184.66 per 1000 person-year) was significantly higher in the KD cohort than in the control cohort (124.99 per 1000 person-years). After adjusting for potential confounders, the adjusted hazard ratios of asthma and allergic rhinitis were 1.51 (95% confidence interval = 1.17-1.95) and 1.30 (95% confidence interval = 1.04-1.62), respectively. Conclusion We conclude that KD patients were at an increased risk for allergic diseases compared with the comparison cohort.
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Affiliation(s)
- Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Liew WK, Lim CWT, Tan TH, Wong KY, Tai BC, Quek SC, Bever HV. The effect of Kawasaki disease on childhood allergies - a sibling control study. Pediatr Allergy Immunol 2011; 22:488-93. [PMID: 21443753 DOI: 10.1111/j.1399-3038.2011.01149.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Kawasaki disease (KD) is a multisystem inflammatory vasculitis of childhood, with widespread T-helper cell type 1 immune activation. We hypothesize that children who suffered from KD will have a lower risk of developing allergic diseases. STUDY DESIGN This was a cross-sectional study, recruiting children with a history of KD, together with well sibling controls. All children underwent the standardized core ISAAC questionnaire for allergy, physical examination and skin prick test evaluation. McNemar's test was employed to evaluate the effect of Kawasaki disease on allergy. Multivariable analysis based on mixed-effects logistic regression model was used to adjust for potential confounding effect of age and gender. RESULTS One hundred and eighty-six children (93 KD sibling pairs) completed the above evaluation. Allergic rhinitis was more common in patients with KD (crude OR 2.40; 95% CI 1.11-5.62, p=0.024) when compared with controls. The effect was further intensified after accounting for the potential confounding effect of age and gender (adjusted OR=2.90; 95% CI 1.27-6.60). Children in whom KD occurred beyond the age of 12 months had more allergic rhinitis (crude OR 4.00, 95% CI 1.29-16.44, p=0.012), 'any' allergies (crude OR 3.75, 95% CI 1.19-15.52, p=0.019) and Blomia tropicalis sensitization (crude OR 2.57, 95% CI 1.02-7.28, p=0.043) when compared with their sibling controls. Interestingly, children in whom KD course resulted in no coronary artery abnormalities have more allergic rhinitis (crude OR 8.50, 95% CI 2.02-75.85, p=0.003) and 'any' allergies (crude OR 5.00, 95% CI 1.41-26.94, p=0.011), when compared with their sibling controls. CONCLUSION Kawasaki disease may be a risk factor for subsequent allergic diseases. We postulate that KD occurs more frequently in children at risk of immune disequilibrium, with an abnormal inflammatory response initially, and subsequently more allergic manifestations.
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Affiliation(s)
- Woei Kang Liew
- Department of Paediatrics Medicine, KK Women's & Children's Hospital, Singapore.
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Giordani L, Quaranta MG, Marchesi A, Straface E, Pietraforte D, Villani A, Malorni W, Del Principe D, Viora M. Increased frequency of immunoglobulin (Ig)A-secreting cells following Toll-like receptor (TLR)-9 engagement in patients with Kawasaki disease. Clin Exp Immunol 2010; 163:346-53. [PMID: 21175593 DOI: 10.1111/j.1365-2249.2010.04297.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Kawasaki disease (KD) is an acute vasculitis affecting mainly infants and children. Human B cells express Toll-like receptor (TLR)-9, whose natural ligands are unmethylated cytosine-guanine dinucleotide (CpG) motifs characteristic of bacterial DNA. The aim of this study was to clarify the pathogenesis of KD analysing the activation status of peripheral blood mononuclear cells (PBMC), focusing on B lymphocyte activation and functions. Ten patients and 10 age-matched healthy donors were recruited from the Bambino Gesù Hospital of Rome, Italy and enrolled into this study. We determined phenotype profile and immunoglobulin (Ig) production of PBMC from KD patients and age-matched controls. We found that the frequency of CD19(+) B lymphocytes and CD19(+) /CD86(+) activated B lymphocytes from KD patients during the acute phase before therapy was increased significantly. Moreover, B lymphocytes of acute-phase KD patients were more prone to CpG oligodeoxynucleotide (ODN) activation compared with the age-matched controls, as assessed by a significant increase of the number of IgA-secreting cells (SC). In the same patients we found a marked increase of IgM, IgG, interleukin (IL)-6 and tumour necrosis factor (TNF)-α production compared with the control group. In addition, in two convalescent KD patients, conventional treatment with intravenous immunoglobulin (IVIG) restored the normal frequency of CD19(+) B cells, the number of IgA-, IgM- and IgG-SC and the production of IL-6 and TNF-α. Our findings indicate that the percentages of peripheral B lymphocytes of acute-phase KD patients are increased and are prone to bacterial activation in terms of increased numbers of IgA-SC and increased production of IL-6 and TNF-α inflammatory cytokines. Thus, our data support the hypothesis of an infectious triggering in KD.
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Affiliation(s)
- L Giordani
- Department of Therapeutic Research and Medicine Evaluation, Istituto Superiore di Sanità, Rome, Italy
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Hsueh KC, Lin YJ, Chang JS, Wan L, Tsai FJ. BTNL2 gene polymorphisms may be associated with susceptibility to Kawasaki disease and formation of coronary artery lesions in Taiwanese children. Eur J Pediatr 2010; 169:713-9. [PMID: 19882345 DOI: 10.1007/s00431-009-1099-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Accepted: 10/15/2009] [Indexed: 10/20/2022]
Abstract
The butyrophilin-like 2 (BTNL2) gene is a member of the B7 receptor family that probably functions as a T cell costimulatory molecule. Because altered T cell functions are implicated in dysregulation of the immune response seen in Kawasaki disease (KD), it is reasonable to speculate that BTNL2 gene is involved in the pathophysiology of KD. The purpose of this study was to investigate whether polymorphisms of the BTNL2 gene are associated with KD and the development of coronary artery lesions (CALs) in Taiwanese children. Nine-three patients with KD and 669 ethnically matched healthy controls were genotyped for BTNL2 gene rs1555115 C/G and rs2395158 A/G polymorphisms. The frequency of GG genotype of rs 1555115 was significantly higher in KD patients compared with controls (2.2% vs 0.2%, P = 0.012). The odds ratio for developing KD in individuals with rs 1555115 GG genotype was 14.7 (95% confidence interval, 2.04-105.5, P = 0.003) compared with individuals with rs 1555115 CG and CC genotypes. No significant difference was observed in the genotype and allelic frequencies of rs 2395158 polymorphism between KD patients and controls. However, the frequency of the G allele of rs 2395158 was significantly higher in KD patients with CALs than in those without CALs (P = 0.001). No significant difference was observed in the genotype and allelic frequencies of rs 1555115 polymorphism between KD patients with and without CALs. In conclusion, our results suggest that BTNL2 gene polymorphisms might be genetic markers of KD susceptibility and risk of coronary artery complication in Taiwanese children.
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Affiliation(s)
- Kai-Chung Hsueh
- Children's Medical Center, China Medical University Hospital, Taichung, Taiwan.
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Huang FY, Chang TY, Chen MR, Hsu CH, Lee HC, Lin SP, Kao HA, Chiu NC, Chi H, Liu TYC, Liu HF, Dang CW, Chu CC, Lin M, Sung TC, Lee YJ. Genetic Variations of HLA-DRB1 and Susceptibility to Kawasaki Disease in Taiwanese Children. Hum Immunol 2007; 68:69-74. [PMID: 17207714 DOI: 10.1016/j.humimm.2006.10.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2006] [Accepted: 10/27/2006] [Indexed: 01/01/2023]
Abstract
Although some previous studies have reported that genetic and immunologic factors play important roles in the pathogenesis of Kawasaki disease (KD), the etiologic factors of this enigmatic pediatric disease are still poorly understood. The purpose of this study was to investigate whether polymorphisms of the human leukocyte antigen DRB1 (HLA-DRB1) gene are associated with KD and the development of coronary artery lesions (CAL) in Taiwanese children. Genomic DNA was extracted from whole blood samples from 145 children with KD and 331 healthy controls. The HLA-DRB1 gene was genotyped by polymerase chain reaction (PCR) and sequence-based typing assays. We found that the distribution of HLA-DRB1 allele families and alleles in children with KD did not differ from that in healthy controls. Stratified analysis did not demonstrate any association between particular HLA-DRB1 allele families or alleles and the development of CAL in children with KD. These findings suggest that susceptibility to KD and CAL is not associated with the HLA-DRB1 gene in a Taiwanese population. If immunogenetic determinants are involved in this disease and its complications in Taiwanese children, they must involve genes other than HLA-DRB1.
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Affiliation(s)
- Fu-Yuan Huang
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
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Berlana D, Vidaller A, Jódar R, Fort E, Domingo A, Pastó L. Changes in biochemical, hematological and immunological profiles after low-dose intravenous immunoglobulin administration in patients with hypogammaglobulinemia. Transfus Clin Biol 2006; 12:433-40. [PMID: 16616571 DOI: 10.1016/j.tracli.2006.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2005] [Accepted: 02/24/2006] [Indexed: 10/24/2022]
Abstract
We assessed the immediate effect of intravenous immunoglobulins (IVIG) on the biochemical, immunological and hematological profiles in patients with hypogammaglobulinemia. Over a period of three months, patients with antibody deficiencies, who had been established on stable IVIG treatment as replacement therapy in our hospital, were enrolled in the study. Participants underwent pre-therapy determinations of their biochemical, immunological and hematological profiles. Laboratory determinations were repeated after completion of IVIG infusions. Over the study period, fourteen patients were enrolled and a total of 34 pre- and post-IVIG infusion determinations were performed and results compared. We found that low-dose IVIG treatment in patients with hypogammaglobulinemia results in post-infusion biochemical and hematological changes, as follows: an increase in total protein concentration and a reduction in albumin, total cholesterol, sodium and alkaline phosphatase concentrations as well as lymphocyte and platelet counts. All these biochemical and cellular changes seems to be transient, since they were not observed in the subsequent pre-infusion determination. However, in other patient populations, some of these changes might differ, depending on the dose of IVIG administered and the baseline condition and immunological status of the patient.
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Affiliation(s)
- David Berlana
- Pharmacy Service, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain
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Matsubara K, Fukaya T, Miwa K, Shibayama N, Nigami H, Harigaya H, Nozaki H, Hirata T, Baba K, Suzuki T, Ishiguro A. Development of serum IgM antibodies against superantigens of Staphylococcus aureus and Streptococcus pyogenes in Kawasaki disease. Clin Exp Immunol 2006; 143:427-34. [PMID: 16487241 PMCID: PMC1809617 DOI: 10.1111/j.1365-2249.2006.03015.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To serologically determine the association of microbial superantigens and the pathogenesis of Kawasaki disease (KD), we conducted a case-control study. Serum IgG and IgM antibodies against staphylococcal enterotoxin A (SEA), SEB, SEC, toxic shock syndrome toxin-1 (TSST-1), and streptococcal pyrogenic exotoxin A (SPEA) were measured by an enzyme-linked immunosorbent assay in 293 serum samples from 65 KD patients on clinical days 1-28 and 120 control samples. The administration of immunoglobulin products, which contain high concentrations of IgG antibodies against all the superantigens, directly elevated antitoxin IgG antibodies in KD patients. In contrast, antitoxin IgM antibodies were not detected in immunoglobulin products. Actually, we found a significant elevation of IgM antibodies against SEA in KD patients in the first (median titre: 0.020, P < 0.01 versus control), second (0.024, P < 0.001), third (0.030, P < 0.001) and fourth (0.038, P < 0.001) weeks, compared to the controls (0.015). Significant differences of IgM antibodies were also true for SEB, TSST-1, and SPEA throughout the first to fourth weeks, and for SEC throughout the second to fourth weeks. The prevalence of KD patients having high IgM titres (> mean + 2SD of control values) to the 5 superantigens was increased with the clinical weeks, and reached 29-43% of KD subjects at the fourth week. This is the first study that describes kinetics of IgM antibodies against superantigens and clarifies the serological significance throughout the clinical course of KD. Our results suggest that multiple superantigens involve in the pathogenesis of KD.
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Affiliation(s)
- K Matsubara
- Department of Paediatrics, Nishi-Kobe Medical Centre, 5-7-1 Kojidai, Nishi-ku, Kobe 651-2273, Japan.
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Suzuki H, Takeuchi T, Minami T, Shima Y, Iwahashi S, Shibuta S, Uemura S, Kounami S, Aoyagi N, Yoshikawa N. Neoplasms in three patients following Kawasaki disease. Pediatr Int 2005; 47:217-9. [PMID: 15852529 DOI: 10.1111/j.1442-200x.2005.02028.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama 641-0012, Japan.
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Shingadia D, O'Gorman M, Rowley AH, Shulman ST. Surface and cytoplasmic immunoglobulin expression in circulating B-lymphocytes in acute Kawasaki disease. Pediatr Res 2001; 50:538-43. [PMID: 11568300 DOI: 10.1203/00006450-200110000-00019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Kawasaki disease (KD) is an acute vasculitis of young childhood predominantly affecting the coronary arteries. IgA plasma cells have been found to infiltrate vascular and nonvascular tissues in fatal acute KD. To determine whether IgA B-lymphocytes were increased in the peripheral blood of patients with KD, we performed three-color flow cytometry to detect surface and cytoplasmic immunoglobulin expression (IgA, IgM, IgD, and IgG) of peripheral B-lymphocytes in KD patients during the acute, subacute, and convalescent stages of illness and in age-matched febrile and afebrile pediatric controls. Surprisingly, absolute numbers of B-lymphocytes expressing IgA were found to be significantly lower in peripheral blood of acute KD patients compared with febrile and afebrile pediatric controls. These findings indicate that IgA plasma cells are not present in KD tissue as a result of excess numbers of these IgA B-lymphocytes in peripheral blood. We speculate that IgA B-lymphocytes are selectively withdrawn from the peripheral circulation into KD target tissues as part of a specific IgA immune response.
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Affiliation(s)
- D Shingadia
- Divisions of Infectious Diseases, Department of Pediatrics, Children' Memorial Hospital/Northwestern University, Chicago IL 60614, USA.
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Affiliation(s)
- A Fattorossi
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
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Abstract
Human lymphotropic viruses interacting with human immune systems may cause a wide spectrum of human diseases. Kawasaki disease has been thought to be related to events associated with infection, although a direct causative role has not been clearly demonstrated. In this concise review, the reported relationship between human lymphotropic viruses and Kawasaki disease is briefly described.
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Affiliation(s)
- M Okano
- Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan
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Jason J, Montana E, Donald JF, Seidman M, Inge KL, Campbell R. Kawasaki disease and the T-cell antigen receptor. Hum Immunol 1998; 59:29-38. [PMID: 9544237 DOI: 10.1016/s0198-8859(97)00233-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We investigated the evidence for an infectious etiology of Kawasaki disease (KD), an acute vasculitis of unknown etiology, by assessing the effects of KD on the T cell antigen receptor variable beta region families (V beta). Using 3-color flow cytometry, we studied KD patients pre- and post-intravenous gamma globulin (IVIG) therapy and at > 40 days post therapy, additionally comparing them to matched pediatric control patients (PCC) and their own healthy parents (one parent/KD child). Of all the V beta families examined, only V beta 2 exhibited statistically significant differences, between the pre- and post-IVIG samples and preIVIG and parent samples. No associations were found between V beta 2 findings and T cell memory, activation, or adhesion markers. For 2 KD patients, 4 parents, and 1 PCC participant, > 15% of resting CD8+ lymphocytes and > 15% of blastic CD8+ lymphocytes expressed a single V beta family, which varied by individual, without similar expansions in the CD4+ cell populations. One of the participants with this abnormality was the only one with significant cardiac abnormalities. For all participants with the V beta abnormality, other T-cell abnormalities were extensive and involved both CD4+ and CD8+ cells. We suggest that V beta 2 changes do occur in KD, as previously reported. However, these may not be involved in disease pathogenesis. Other V beta changes also occur. Those occurring in parents may reflect asymptomatic reinfection with an infectious agent causing KD. Further, some KD patients may have restricted cytotoxic T-cell responses to that as yet unidentified agent; this restricted response may be associated with more severe cardiac involvement.
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Affiliation(s)
- J Jason
- Department of Health and Human Services, Public Health Service, Atlanta, GA, USA
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