Yokota S
Department of Pediatrics, Yokohama City University School of Medicine, Japan.
Acta Paediatr Jpn. 1991 Dec;33(6):756-64. doi: 10.1111/j.1442-200x.1991.tb02605.x.
Local inflammatory reactivation of a previous BCG inoculation site is a specific and early manifestations of Kawasaki disease (KD). It is postulated that the erythematous changes at the BCG site are part of a generalized activation of the immune system, and that molecules cross-reacting between the infectious agent involved and mycobacterial BCG antigens contribute to the inflammatory process. To detect the cross-reacting molecules, the antibody responses to mycobacterial antigens were examined in 21 patients by IgG-immuno-blotting using acute and convalescent phase sera. Markedly increased levels of antibody against mycobacterial 65kDa protein were detected in all convalescent but in none of the acute sera. Since the antibodies detected are also directed to recombinant 65kDa heat shock protein (HSP65), HSP65 may be related to the initial phase of KD. Moreover, peripheral lymphocytes from convalescent KD patients proliferated in culture in the presence of HSP65, suggesting the sensitization of lymphocytes to HSP65, and gamma delta TCR(+) T cells in the peripheral blood were increased in half the KD patients. Thus, HSP65 is a potent factor involved in activation of the immune system, and consequent endothelial damage in the initial phase of KD.
既往卡介苗接种部位的局部炎症再激活是川崎病（KD）的一种特异性早期表现。据推测，卡介苗接种部位的红斑变化是免疫系统全身性激活的一部分，并且参与感染的病原体与分枝杆菌卡介苗抗原之间的交叉反应分子促成了炎症过程。为了检测交叉反应分子，通过使用急性期和恢复期血清的IgG免疫印迹法，对21例患者针对分枝杆菌抗原的抗体反应进行了检测。在所有恢复期血清中均检测到针对分枝杆菌65kDa蛋白的抗体水平显著升高，而急性期血清中均未检测到。由于检测到的抗体也针对重组65kDa热休克蛋白（HSP65），因此HSP65可能与KD的初始阶段有关。此外，恢复期KD患者的外周淋巴细胞在HSP65存在的情况下在培养中增殖，提示淋巴细胞对HSP65致敏，并且一半的KD患者外周血中的γδTCR(+)T细胞增加。因此，HSP65是参与KD初始阶段免疫系统激活及随之而来的内皮损伤的一个重要因素。
