DOI QR코드

DOI QR Code

T-Helper Cytokine Profiles in Patients with Kawasaki Disease

  • Lee, Sang Bum (Department of Pediatrics, Kyungbook National University School of Medicine) ;
  • Kim, Young Hyun (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Hyun, Myung Chul (Department of Pediatrics, Kyungbook National University School of Medicine) ;
  • Kim, Yeo Hyang (Department of Pediatrics, Kyungbook National University School of Medicine) ;
  • Kim, Hee Sun (Department of Microbiology, Yeungnam University College of Medicine) ;
  • Lee, Young Hwan (Department of Pediatrics, Yeungnam University College of Medicine)
  • Received : 2014.12.15
  • Accepted : 2015.06.02
  • Published : 2015.11.30

Abstract

Background and Objectives: Kawasaki disease is an acute systemic vasculitis of which pathogenesis suspected is caused by immune dysregulation. The goal of this study is to evaluate the activation pattern of T helper cell type 1 (Th1) and T helper cell type 2 (Th2) in patients with Kawasaki disease. Subjects and Methods: Prospective study of 60 patients (male 36, female 24) with diagnosis of Kawasaki disease were enrolled. One hundred and eighty blood samples from these patients were collected according to the different clinical stages {before initial intravenous immunoglobulin (IVIG), 5 days after initial IVIG, 2 months after initial IVIG}. The plasma level of Th1 cytokines; interferon-gamma ($IFN-{\gamma}$) & interleukin (IL)-2 and Th2 cytokines; IL-4 & IL-10 were measured by enzyme-liked immunosorbent assay. Results: In all patients, the plasma level of Th1 cytokines ($IFN-{\gamma}$, IL-2) and Th2 cytokines (IL-4 and IL-10) were markedly elevated during the acute stage of Kawasaki disease. Since then, the plasma level of all these cytokines decreased significantly along with the process of clinical stages. Regardless of the existence of coronary artery lesion or no response to initial IVIG treatment, there were no significant differences between them. Conclusion: These data suggest that both Th1 and Th2 cells may be activated simultaneously during the acute stage of Kawasaki disease. Further studies are therefore required to establish the difference of activation pattern of T helper cells between Kawasaki disease and other inflammatory diseases.

Keywords

Acknowledgement

Supported by : Kyungpook National University Hospital

References

  1. Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. Arerugi 1967;16:178-222.
  2. Takahashi K, Oharaseki T, Yokouchi Y. Update on etio and immunopathogenesis of Kawasaki disease. Curr Opin Rheumatol 2014;26:31-6. https://doi.org/10.1097/BOR.0000000000000010
  3. Leung DY. Immunologic aspects of Kawasaki syndrome. J Rheumatol Suppl 1990;24:15-8.
  4. de Inocencio J, Hirsch R. The role of T cells in Kawasaki disease. Crit Rev Immunol 1995;15:349-57. https://doi.org/10.1615/CritRevImmunol.v15.i3-4.80
  5. Jason J, Gregg L, Han A, et al. Immunoregulatory changes in Kawasaki disease. Clin Immunol Immunopathol 1997;84:296-306. https://doi.org/10.1006/clin.1997.4376
  6. Brogan PA, Shah V, Clarke LA, Dillon MJ, Klein N. T cell activation profiles in Kawasaki disease. Clin Exp Immunol 2008;151:267-74.
  7. Matsubara T, Katayama K, Matsuoka T, Fujiwara M, Koga M, Furukawa S. Decreased interferon-gamma(IFN-gamma)-producing T cells in patients with acute Kawasaki disease. Clin Exp Immunol 1999;116:554-7. https://doi.org/10.1046/j.1365-2249.1999.00899.x
  8. Liew WK, Lim CW, Tan TH, et al. The effect of Kawasaki disease on childhood allergies - a sibling control study. Pediatr Allergy Immunol 2011;22:488-93. https://doi.org/10.1111/j.1399-3038.2011.01149.x
  9. Matsuoka S, Tatara K, Nakagawa R, Mori K, Kuroda Y. Tendency toward atopy in Kawasaki disease. Eur J Pediatr 1997;156:30-2.
  10. Kimura J, Takada H, Nomura A, et al. Th1 and Th2 cytokine production is suppressed at the level of transcription regulation in Kawasaki disease. Clin Exp Immunol 2004;137:444-9. https://doi.org/10.1111/j.1365-2249.2004.02506.x
  11. Kuo HC, Wang CL, Liang CD, et al. Association of lower eosinophilrelated T helper 2 (Th2) cytokines with coronary artery lesions in Kawasaki disease. Pediatr Allergy Immunol 2009;20:266-72. https://doi.org/10.1111/j.1399-3038.2008.00779.x
  12. Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2004; 110:2747-71. https://doi.org/10.1161/01.CIR.0000145143.19711.78
  13. Japan Kawasaki Disease Research Committee. Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo: Ministry of Health and Welfare;1984.
  14. Jia S, Li C, Wang G, Yang J, Zu Y. The T helper type 17/regulatory T cell imbalance in patients with acute Kawasaki disease. Clin Exp Immunol 2010;162:131-7. https://doi.org/10.1111/j.1365-2249.2010.04236.x
  15. Wang Y, Wang W, Gong F, et al. Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1/Th2 cytokine profiles in patients with Kawasaki disease. Arthritis Rheum 2013;65:805-14. https://doi.org/10.1002/art.37815
  16. Strachan DP. Hay fever, hygiene, and household size. BMJ 1989;299:1259-60. https://doi.org/10.1136/bmj.299.6710.1259
  17. Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic disease: an update. Clin Exp Immunol 2010;160:1-9.
  18. Del Prete G. The concept of type-1 and type-2 helper T cells and their cytokines in humans. Int Rev Immunol 1998;16:427-55. https://doi.org/10.3109/08830189809043004
  19. Mosmann TR, Cherwinski H, Bond MW, Giedlin MA, Coffman RL. Two types of murine helper T cell clone. I. Definition according to profiles of lymphokine activities and secreted proteins. J Immunol 1986;136:2348-57.
  20. Bertotto A, Spinozzi F, Vagliasindi C, Radicioni M, De Rosa O, Vaccaro R. Tuberculin skin test reactivity in Kawasaki disease. Pediatr Res 1997;41(4 Pt 1):560-2. https://doi.org/10.1203/00006450-199704000-00017
  21. Sinha R, Balakumar T. BCG reactivation: a useful diagnostic tool even for incomplete Kawasaki disease. Arch Dis Child 2005;90:891. https://doi.org/10.1136/adc.2004.071332
  22. Shirakawa T, Enomoto T, Shimazu S, Hopkin JM. The inverse association between tuberculin responses and atopic disorder. Science 1997;275:77-9. https://doi.org/10.1126/science.275.5296.77
  23. Brosius CL, Newburger JW, Burns JC, Hojnowski-Diaz P, Zierler S, Leung DY. Increased prevalence of atopic dermatitis in Kawasaki disease. Pediatr Infect Dis J 1988;7:863-6. https://doi.org/10.1097/00006454-198807120-00006
  24. Kuo HC, Chang WC, Yang KD, et al. Kawasaki disease and subsequent risk of allergic disease: a population-based matched cohort study. BMC Pediatr 2013;13:38. https://doi.org/10.1186/1471-2431-13-38

Cited by

  1. The CXCL10/CXCR3 Axis and Cardiac Inflammation: Implications for Immunotherapy to Treat Infectious and Noninfectious Diseases of the Heart vol.2016, pp.None, 2015, https://doi.org/10.1155/2016/4396368
  2. The Roles of Genetic Factors in Kawasaki Disease: A Systematic Review and Meta-analysis of Genetic Association Studies vol.39, pp.2, 2018, https://doi.org/10.1007/s00246-017-1760-0
  3. The risk of hospitalization for respiratory tract infection (RTI) in children who are treated with high-dose IVIG in Kawasaki Disease: a nationwide population-based matched cohort study vol.6, pp.None, 2015, https://doi.org/10.7717/peerj.4539
  4. The IL-1B Gene Polymorphisms rs16944 and rs1143627 Contribute to an Increased Risk of Coronary Artery Lesions in Southern Chinese Children with Kawasaki Disease vol.2019, pp.None, 2015, https://doi.org/10.1155/2019/4730507
  5. Distribution of distinct subsets of circulating T follicular helper cells in Kawasaki disease vol.19, pp.1, 2015, https://doi.org/10.1186/s12887-019-1412-z
  6. Effects of changes on gut microbiota in children with acute Kawasaki disease vol.8, pp.None, 2015, https://doi.org/10.7717/peerj.9698
  7. Epigenetic Regulation of Macrophage Marker Expression Profiles in Kawasaki Disease vol.8, pp.None, 2015, https://doi.org/10.3389/fped.2020.00129
  8. The Impact of Moderate-Dose Acetylsalicylic Acid in the Reduction of Inflammatory Cytokine and Prevention of Complication in Acute Phase of Kawasaki Disease: The Benefit of Moderate-Dose Acetylsalicyl vol.7, pp.10, 2020, https://doi.org/10.3390/children7100185
  9. Kawasaki Disease and Allergic Diseases vol.8, pp.None, 2015, https://doi.org/10.3389/fped.2020.614386