All issues > Volume 35(12); 1992

Original Article

J Korean Pediatr Soc. 1992;35(12):1657-1666. Published online December 15, 1992.

The Soluble Interleukin 2 Receptor Levels in Kawasaki Disease

Keum Chun KC Kim¹, Dong Soo DS Kim¹

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea

Abstract

Kawasaki disease has been known as an acute febrile mucocutaneous lymph node syndrome since 1967. But its definite pathophysiology still remains unclear. In order to study the immunologic basis for immunologic abnormalities in this disease, we studied the level of soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6) and C-reactive protein (CRP) at the acute and convalescent phases of the disease, comparing them with the same phases in other diseases and a control group. The subjects were 20 patients with Kawasaki disease, 9 patients of acute lymphocytic leukemia, 8 patients of enteroviral meningitis, 12 patients of systemic lupus erythematosus and 7 of a control group whose members had visited Severance Hospital from Sept. 1990 to July 1991. All the sera were kept in deep freeze at -70 C until use. The serum sIL-2R levels were measureed by the Sandwich ELISA method of T cell sciences, the serum IL-6 levels by the Sandwich ELISA method (Fujirebio Inc. Tokyo, Japan), and serum CRP levels by fluorescence polarization immunoassay (TDx: Abbott Inc). The results were as follows: In the acute phase of Kawasaki disease, the mean serum sIL-2R level was 3,275¡¾1,780 U/ml which were significantly higher than 315¡¾145 U/ml in the control group and suggested some relation to T-cell activation. In 13 out of 20 Kawasaki patients the mean serum sIL-2R levels at the subacute and recovery phases were 1,841¡¾930 U/ml, significantly lower than that of acute phase but still higher than control group. The sIL-2R levels in acute lymphocytic leukemia, menigitis and systemic lupus erythematosus patients were 1,290¡¾257 U/ml, 1,290¡¾257 U/ml and 820¡¾321 U/ml each. All levels were higher than those founded in the control group but significantly lower than those of acute phase Kawasaki disease patients. The mean observed level of IL-6 in the acute phase of Kawasaki disease was 136.9¡¾24.5 pg/ml. There was linear correlation between serum sIL-2R and IL-6 and increased IL-6 levels suggesting some relation to T-cell activation. The mean level of CRP in the acute phase was 13.9¡¾6.5 mg/dl, but there was no linear correlation with sIL-2R levels. Increased platelet counts in the recovery phase did not relate with sIL-2R levels. In conclusion, serum sIL-2R levels increased significantly in the acute phase of Kawasaki disease and decreased significantly in the recovery phase but it was consistently higher than control group. This suggested persistent activation of lymphocytes during the disease. Serum IL-2R levels showed linear correlation with serum IL-6 levels. Thus, increased serum IL-6 levels seemed to have some relation to T-cell activation.

Keywords :Kawasaki disease, Soluble interleukin-2 receptor