Dynamics of immunocyte activation during intravenous immunoglobulin treatment in Kawasaki disease

C. Matsuguma, H. Wakiguchi, Y. Suzuki, S. Okada, T. Furuta, Y. Ohnishi, Y. Azuma, S. Ohga, S. Hasegawa

Research output: Contribution to journalArticle

Abstract

Objectives: Kawasaki disease (KD) is a systemic vasculitis of early childhood. Intravenous immunoglobulin (IVIG) is the standard treatment for KD. However, IVIG is not effective in approximately 15% of children with KD, and the mechanisms for this are unclear. We investigated changes in monocyte and T-cell activation from pre- to post-IVIG in IVIG-effective and IVIG-resistant KD. Method: We analysed peripheral CD14+CD16+ cells and human leucocyte antigen-DR (HLA-DR) expression on CD4+ and CD8+ cells in 46 children with KD who were admitted to Yamaguchi University Hospital between January 2011 and May 2016. We compared the kinetics in the absolute numbers of CD14+CD16+ cells, CD4+HLA-DR+ cells, and CD8+HLA-DR+ cells before and after IVIG treatment between IVIG-effective and IVIG-resistant groups. Results: Among the 46 subjects, 30 had IVIG-effective KD and 16 had IVIG-resistant KD. The absolute number of CD14+CD16+ cells in the IVIG-effective group decreased significantly after IVIG, while that in the IVIG-resistant group showed no change after IVIG. The absolute number of CD4+HLA-DR+ cells increased significantly after IVIG in both groups. The absolute number of CD8+HLA-DR+ cells before IVIG was low and significantly increased after IVIG in the IVIG-resistant group, while that in the IVIG-effective group showed no change after IVIG. Conclusions: Our results suggest that insufficient control of monocyte suppression and T-cell activation, especially in terms of the CD8-related immune system, are associated with IVIG resistance. The restoration of T-cell suppression may be important for KD recovery. These findings provide insight into the mechanism of IVIG resistance.

Original languageEnglish
Pages (from-to)491-496
Number of pages6
JournalScandinavian Journal of Rheumatology
Volume48
Issue number6
DOIs
Publication statusPublished - Nov 2 2019

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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    Matsuguma, C., Wakiguchi, H., Suzuki, Y., Okada, S., Furuta, T., Ohnishi, Y., Azuma, Y., Ohga, S., & Hasegawa, S. (2019). Dynamics of immunocyte activation during intravenous immunoglobulin treatment in Kawasaki disease. Scandinavian Journal of Rheumatology, 48(6), 491-496. https://doi.org/10.1080/03009742.2019.1604992