Immunologic Alterations of Peripheral Mononuclear Cells by Intravenous Immunoglobulin in the Acute Stage of Kawasaki disease.
- Author:
Ji Whan HAN
1
;
Kyung Yil LEE
;
Kyong Su LEE
Author Information
1. Department of Pediatrics, Catholic University College of Medicine, Seoul, Korea.
- Publication Type:In Vitro ; Original Article
- Keywords:
Kawasaki disease;
Intravenous immunoglobulin treatment;
Cytokine production;
Immunoglobulin production;
Monocyte;
B cell
- MeSH:
Aneurysm;
B-Lymphocytes;
Coronary Vessels;
Enzyme-Linked Immunosorbent Assay;
Gene Expression;
Humans;
Immunoglobulin A;
Immunoglobulin G;
Immunoglobulin M;
Immunoglobulins*;
Immunoglobulins, Intravenous;
Incidence;
Interleukin-4;
Interleukin-6;
Monocytes;
Mucocutaneous Lymph Node Syndrome*;
Phytolacca americana;
Polymerase Chain Reaction;
Reverse Transcription;
RNA, Messenger;
Tumor Necrosis Factor-alpha
- From:Journal of the Korean Pediatric Society
1998;41(6):813-824
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: High dose intravenous immunoglobulin (IVIG) therapy is effective in reducing the incidence of coronary artery aneurysm in Kawasaki disease (KD) patients, however, the precise mechanisms by which IVIG reverses the immune activation is unknown. METHODS: The sera and peripheral mononuclear cells (PBMCs) were obtained from 10 KD patients in the acute stage (24 hrs before) and 24 hrs after one dose of IVIG (2g/kg) treatment. We measured serum interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) and compared them to the messenger RNA expression of the PBMCs by reverse transcription polymerase chain reaction. We also investigated the cytokines' or immunoglobulins' production of PBMCs which were stimulated with phytohemagglutinin-P (PHA-P) or pokeweed mitogen (PWM, without in vitro IVIG treatment) by enzyme-linked immunosorbent assay. RESULTS: The serum levels of IL-6 and TNF-alpha decreased significantly after IVIG treatment. However, the gene expression of IL-6 and TNF-alpha showed no significant difference after IVIG treatment. IL-6 and TNF-alpha productions of PBMCs stimulated with PHA-P decreased significantly after IVIG treatment, however, IL-4 and IFN-gamma production showed no significant differences. IL-6 production of PBMCs stimulated with PWM also decreased significantly after IVIG treatment, but TNF-alpha did not change significantly. The synthesis of IgG, IgM, IgA and IgG1 after IVIG treatment showed a significant decrease, and that of IgG2 showed a slight decrease, but was not statistically significant. CONCLUSION: The results demonstrate that the administration of IVIG in the acute stage of KD resulted in the alterations of activated immunologic abnormalities, especially in monocytes and B cells.
