Wakiguchi Hiroyuki, Hasegawa Shunji, Suzuki Yasuo, Kudo Keiko, Ichiyama Takashi
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Pediatr Res. 2015 Apr;77(4):536-40. doi: 10.1038/pr.2015.12. Epub 2015 Jan 12.
Kawasaki disease (KD) is an acute febrile illness associated with the development of vasculitis. Administration of intravenous immunoglobulin (IVIG) is the standard treatment for KD. However, IVIG treatment is not effective in approximately 15% of children with KD. Some reports have presented evidence of immunological responses in IVIG-resistant KD patients. We assessed the possibility that T-cell activation is a contributing mechanism underlying this phenomenon.
We analyzed human leukocyte antigen-DR (HLA-DR) expression on peripheral blood CD4+ and CD8+ T cells in 82 children with KD who were admitted to the hospital between October 2007 and February 2012. We compared the percentages of HLA-DR+ T cells among the CD4+ T-cell and CD8+ T-cell populations for the IVIG-effective and IVIG-resistant groups.
Among the 82 subjects, 51 had IVIG-effective KD and 31 children had IVIG-resistant KD. The percentages of HLA-DR+ T cells among the CD4+ T-cell and CD8+ T-cell populations in the IVIG-effective group were significantly lower than those in the IVIG-resistant group.
Our results suggest that increased T-cell HLA-DR expression is associated with IVIG resistance in KD patients, indicating that HLA-DR expression would be a useful tool for predicting IVIG responsiveness during KD pathogenesis.
川崎病（KD）是一种与血管炎发展相关的急性发热性疾病。静脉注射免疫球蛋白（IVIG）是KD的标准治疗方法。然而，IVIG治疗对约15%的KD患儿无效。一些报告提供了IVIG抵抗性KD患者免疫反应的证据。我们评估了T细胞活化是这一现象潜在促成机制的可能性。
我们分析了2007年10月至2012年2月期间入院的82例KD患儿外周血CD4+和CD8+T细胞上人类白细胞抗原-DR（HLA-DR）的表达。我们比较了IVIG有效组和IVIG抵抗组中CD4+T细胞和CD8+T细胞群体中HLA-DR+T细胞的百分比。
在82名受试者中，51例患有IVIG有效的KD，31例患儿患有IVIG抵抗性KD。IVIG有效组中CD4+T细胞和CD8+T细胞群体中HLA-DR+T细胞的百分比显著低于IVIG抵抗组。
我们的结果表明，T细胞HLA-DR表达增加与KD患者的IVIG抵抗相关，表明HLA-DR表达将是预测KD发病机制中IVIG反应性的有用工具。
