Nomura Yuichi, Masuda Kiminori, Maeno Nobuaki, Yoshinaga Masao, Kawano Yoshifumi
Department of Pediatrics, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan.
Int Arch Allergy Immunol. 2004 Oct;135(2):161-5. doi: 10.1159/000080660. Epub 2004 Sep 2.
Elevations of various cytokines, including Th1 and Th2 cytokines, have been reported in the acute phase of Kawasaki syndrome (KS). As interleukin (IL)-18 plays an important role in the Th1 cell response, investigating the relevance of IL-18 in KS should be helpful in determining the pathophysiology of KS. Therefore, we examined the IL-18 values in KS.
Serum IL-18 values were measured by an enzyme-linked immunosorbent assay. Samples were obtained from 41 patients in the acute and subacute phase of KS, 35 age-matched febrile controls and 13 afebrile controls.
No difference was observed in the values of white blood cell counts or C-reactive protein between acute-phase KS patients and febrile controls. On the contrary, acute-phase KS patients showed a significantly lower mean IL-18 value (398 +/- 206 pg/ml) than that of febrile controls (584 +/- 307 pg/ml) (p = 0.006). Subacute-phase KS patients showed a significantly elevated level of IL-18 (517 +/- 276 pg/ml) compared to acute-phase patients (p = 0.0008). The IL-18 values in the subacute-phase patients showed a significant positive correlation with the duration of fever (r = 0.427, p = 0.0055) and also with the presence of coronary artery abnormalities (r = 0.332, p = 0.0340). The incidence of elevated IL-18 values in the subacute-phase patients was significantly higher than that in the afebrile controls (p = 0.048).
Patients with KS showed normal IL-18 values in the acute phase and elevated values in the subacute phase. IL-18 pathways were activated in the subacute phase of KS, and subacute IL-18 values might be reflected in the severity of KS.
据报道，在川崎综合征（KS）急性期，包括Th1和Th2细胞因子在内的多种细胞因子会升高。由于白细胞介素（IL）-18在Th1细胞反应中起重要作用，研究IL-18与KS的相关性有助于确定KS的病理生理学机制。因此，我们检测了KS患者的IL-18值。
采用酶联免疫吸附测定法检测血清IL-18值。样本取自41例KS急性期和亚急性期患者、35例年龄匹配的发热对照者以及13例无发热对照者。
急性期KS患者与发热对照者的白细胞计数或C反应蛋白值无差异。相反，急性期KS患者的平均IL-18值（398±206 pg/ml）显著低于发热对照者（584±307 pg/ml）（p = 0.006）。与急性期患者相比，亚急性期KS患者的IL-18水平显著升高（517±276 pg/ml）（p = 0.0008）。亚急性期患者的IL-18值与发热持续时间呈显著正相关（r = 0.427，p = 0.0055），也与冠状动脉异常的存在呈正相关（r = 0.332，p = 0.0340）。亚急性期患者IL-18值升高的发生率显著高于无发热对照者（p = 0.048）。
KS患者急性期IL-18值正常，亚急性期升高。KS亚急性期IL-18通路被激活，亚急性期IL-18值可能反映KS的严重程度。
