All issues > Volume 41(6); 1998

Original Article

J Korean Pediatr Soc. 1998;41(6):813-824. Published online June 15, 1998.

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

Ji-Whan JW Han¹, Kyung-Yil KY Lee¹, Kyong-Su KS Lee¹

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

Correspondence Ji-Whan JW Han ,Email: 1

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 α(TNF-α) 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-α decreased significantly after IVIG treatment. However, the gene expression of IL-6 and TNF-α showed no significant difference after IVIG treatment. IL-6 and TNF-α productions of PBMCs stimulated with PHA-P decreased significantly after IVIG treatment, however, IL-4 and IFN-γ production showed no significant differences. IL-6 production of PBMCs stimulated with PWM also decreased significantly after IVIG treatment, but TNF-α 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.

Keywords :Kawasaki disease, Intravenous immunoglobulin treatment, Cytokine production, Immunoglobulin production, Monocyte, B cell