Leung D Y, Burns J C, Newburger J W, Geha R S
J Clin Invest. 1987 Feb;79(2):468-72. doi: 10.1172/JCI112835.
The effect of intravenous gammaglobulin (IVGG) on the immunoregulatory abnormalities found during acute Kawasaki syndrome (KS) was studied in a randomized trial of IVGG plus aspirin (ASA) versus ASA alone. Before therapy, patients in each treatment group had increased numbers of circulating HLA-DR-bearing Leu 3+ helper T cells, a deficiency of Leu 2+ suppressor/cytotoxic T cells, and increased levels of spontaneous IgG and IgM synthesis by peripheral blood mononuclear cells. There were no significant differences (P greater than 0.1) between immunologic parameters measured on day 1 and day 4 in the ASA-treated group. In contrast, patients treated with ASA plus IVGG had by day 4 a highly significant decrease in HLA-Dr+ Leu 3+ helper T cells (P less than 0.001), an increase in Leu 2+ suppressor/cytotoxic T cells (P less than 0.01), and a decrease in spontaneous IgG (P less than 0.01) and IgM synthesis (P less than 0.001). These changes were associated with a reduction in the secretion of T cell-derived B cell helper factors (P less than 0.001). These findings indicate that treatment with IVGG suppresses the marked T and B cell activation found in patients with acute KS.
在一项静脉注射丙种球蛋白（IVGG）加阿司匹林（ASA）与单用阿司匹林的随机试验中，研究了静脉注射丙种球蛋白对急性川崎综合征（KS）期间发现的免疫调节异常的影响。治疗前，每个治疗组的患者循环中携带HLA-DR的Leu 3 +辅助性T细胞数量增加，Leu 2 +抑制/细胞毒性T细胞缺乏，外周血单个核细胞自发合成IgG和IgM的水平升高。在ASA治疗组中，第1天和第4天测量的免疫参数之间无显著差异（P大于0.1）。相比之下，接受ASA加IVGG治疗的患者到第4天时，HLA-Dr + Leu 3 +辅助性T细胞显著减少（P小于0.001），Leu 2 +抑制/细胞毒性T细胞增加（P小于0.01），自发IgG（P小于0.01）和IgM合成减少（P小于0.001）。这些变化与T细胞衍生的B细胞辅助因子分泌减少有关（P小于0.001）。这些发现表明，IVGG治疗可抑制急性KS患者中明显的T和B细胞活化。
