Brown T J, Crawford S E, Cornwall M L, Garcia F, Shulman S T, Rowley A H
Department of Pediatrics, Northwestern University Medical School, and Children's Memorial Hospital, Chicago, Illinois 60611, USA.
J Infect Dis. 2001 Oct 1;184(7):940-3. doi: 10.1086/323155. Epub 2001 Aug 22.
The pathogenesis of coronary arterial inflammation in acute Kawasaki disease (KD) is unclear. To test the hypothesis that the KD vascular lesion is an activated T lymphocyte-dependent process, immunohistochemical studies were done on coronary artery aneurysms from 8 fatal acute KD cases by using antibodies to CD45RO (activated or memory T lymphocyte), CD8 (cytotoxic T lymphocyte), CD4 (helper T lymphocyte), HAM56 (macrophage), and CD20 (B lymphocyte). Acute KD coronary arteritis was characterized by transmural infiltration of CD45RO T lymphocytes with CD8 T lymphocytes predominating over CD4 T lymphocytes. Macrophages were present primarily in the adventitial layer; B lymphocytes were notably absent. These data lend support to the hypotheses that KD results from infection with an intracellular pathogen, such as a virus, whose antigens are presented by major histocompatibility complex class I molecules, and that CD8 T lymphocytes and macrophages are important in the pathogenesis of KD coronary aneurysms.
急性川崎病（KD）冠状动脉炎症的发病机制尚不清楚。为验证KD血管病变是一个活化T淋巴细胞依赖性过程的假说，我们使用针对CD45RO（活化或记忆T淋巴细胞）、CD8（细胞毒性T淋巴细胞）、CD4（辅助性T淋巴细胞）、HAM56（巨噬细胞）和CD20（B淋巴细胞）的抗体，对8例急性KD致死病例的冠状动脉瘤进行了免疫组织化学研究。急性KD冠状动脉炎的特征是CD45RO T淋巴细胞全层浸润，其中CD8 T淋巴细胞多于CD4 T淋巴细胞。巨噬细胞主要存在于外膜层；明显没有B淋巴细胞。这些数据支持了以下假说：KD是由细胞内病原体（如病毒）感染引起的，其抗原由主要组织相容性复合体I类分子呈递，并且CD8 T淋巴细胞和巨噬细胞在KD冠状动脉瘤的发病机制中起重要作用。
