J Korean Pediatr Soc.  1998 Jun;41(6):813-824.

Immunologic Alterations of Peripheral Mononuclear Cells by Intravenous Immunoglobulin in the Acute Stage of Kawasaki disease

• Han JW
• Lee KY
• Lee KS

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.

Keyword

Kawasaki disease; Intravenous immunoglobulin treatment; Cytokine production; Immunoglobulin production; Monocyte; B cell

MeSH Terms

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
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Immunoglobulins
Immunoglobulins, Intravenous
Interleukin-4
Interleukin-6
RNA, Messenger
Tumor Necrosis Factor-alpha