Kuo Ho-Chang, Wang Chih-Lu, Liang Chi-Di, Yu Hong-Ren, Huang Chien-Fu, Wang Lin, Hwang Kao-Pin, Yang Kuender D
Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan.
Pediatr Allergy Immunol. 2009 May;20(3):266-72. doi: 10.1111/j.1399-3038.2008.00779.x.
Kawasaki disease (KD) is a systemic febrile vasculitis particular coronary artery involvement. Eosinophilia has been found in our and other studies in KD. This study further investigates whether eosinophil-related T helper 2 (Th2) cytokines or the activation marker (eosinophil cationic protein - ECP) is involved in KD with coronary artery lesions (CAL). A total of 95 KD patients were enrolled for this study. Plasma samples were subjected to the measurement of interleukin (IL)-4, IL-5, and eotaxin by Luminex-Bedalyte multiplex beadmates system and to the measurement of ECP by fluoroimmunoassay. Patients with KD had higher eosinophils than controls. Eosinophil-related mediators: IL-4, IL-5, eotaxin, and ECP levels were also higher in KD patients than controls before intravenous immunoglobulin (IVIG) treatment. After IVIG treatment, ECP decreased but IL-4, IL-5, and eotaxin increased significantly. The higher the IL-5 and eosinophil levels after IVIG treatment, the lower rate of CAL was found. Changes of eosinophils after IVIG treatment were positively correlated to changes of IL-5 levels but not ECP levels. An increase of eosinophils and IL-5, but not ECP levels after IVIG treatment, was inversely correlated with CAL formation in KD.
川崎病(KD)是一种全身性发热性血管炎,尤其累及冠状动脉。在我们的研究以及其他关于川崎病的研究中均发现了嗜酸性粒细胞增多现象。本研究进一步探讨嗜酸性粒细胞相关的辅助性T细胞2(Th2)细胞因子或激活标志物(嗜酸性粒细胞阳离子蛋白 - ECP)是否与伴有冠状动脉病变(CAL)的川崎病有关。本研究共纳入95例川崎病患者。血浆样本采用Luminex - Bedalyte多重微珠检测系统检测白细胞介素(IL)-4、IL -5和嗜酸性粒细胞趋化因子,并采用荧光免疫测定法检测ECP。川崎病患者的嗜酸性粒细胞高于对照组。在静脉注射免疫球蛋白(IVIG)治疗前,川崎病患者中嗜酸性粒细胞相关介质:IL -4、IL -5、嗜酸性粒细胞趋化因子和ECP水平也高于对照组。IVIG治疗后,ECP下降,但IL -4、IL -5和嗜酸性粒细胞趋化因子显著升高。IVIG治疗后IL -5和嗜酸性粒细胞水平越高,CAL发生率越低。IVIG治疗后嗜酸性粒细胞的变化与IL -5水平的变化呈正相关,与ECP水平无关。IVIG治疗后嗜酸性粒细胞和IL -5升高,但ECP水平未升高,这与川崎病中CAL的形成呈负相关。