Department of Pharmacy, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Department of Pediatric cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Mediators Inflamm. 2020 Nov 18;2020:5213451. doi: 10.1155/2020/5213451. eCollection 2020.
Immunoglobulin intravenous (IVIG) is widely used in mucocutaneous lymph node syndrome, known as Kawasaki disease (KD). However, the patients' inflammatory response during usage remains unclear. In the present study, the association between inflammatory response and lymphocyte count in children with KD from different ages was evaluated before and after IVIG. The medical records of 50 children with KD were retrospectively reviewed and divided into five groups according to age. As compared with the data from healthy children, the relative neutrophil count of all children with KD was increased, and that of lymphocytes was decreased. The neutrophil/lymphocyte ratio (NLR) was different among all groups and was higher in children aged ≥4 years, as compared with other groups. Following IVIG, the relative neutrophil and lymphocyte counts of all children with KD returned to normal levels. The altered levels of neutrophils and lymphocytes were found to be linearly correlated. The correlation coefficient in the five groups was 0.99, 0.87, 0.91, 0.97 and 0.99, from young to old, respectively ( < 0.01). The age of children with KD was positively correlated with older age ( = 0.91, = 0.03). In patients aged ≥4 years, the absolute CD19 B cell count prior to IVIG increased, and that increase was linearly correlated with the decrease in interleukin-10 (IL-10) following IVIG ( = 0.71, < 0.05). The older the child's age, the better the regulatory effect of IVIG on the KD child's immune response and the recovery of immune equilibrium it achieved. In KD patients aged ≥4 years, the abnormally proliferating CD19 B cells may be involved in the secretion of IL-10 to balance the humoral immunity. In such patients, the combination of the absolute CD19 B cell count prior to IVIG and the decreased levels of IL-10 following IVIG may play a crucial role in evaluating the effect of IVIG in the inflammation.
静脉注射免疫球蛋白（IVIG）广泛用于黏膜皮肤淋巴结综合征，即川崎病（KD）。然而，其在使用过程中对患者炎症反应的影响尚不清楚。本研究评估了不同年龄川崎病患儿使用 IVIG 前后炎症反应与淋巴细胞计数的相关性。回顾性分析 50 例川崎病患儿的病历资料，根据年龄分为 5 组。与健康儿童相比，所有川崎病患儿的相对中性粒细胞计数均升高，淋巴细胞计数降低。所有组间的中性粒细胞/淋巴细胞比值（NLR）不同，≥4 岁儿童的 NLR 高于其他组。IVIG 后，所有川崎病患儿的相对中性粒细胞和淋巴细胞计数均恢复正常。发现中性粒细胞和淋巴细胞水平的变化呈线性相关。5 组的相关系数分别为 0.99、0.87、0.91、0.97 和 0.99，从低龄到高龄（<0.01）。川崎病患儿的年龄与年龄较大呈正相关（=0.91，=0.03）。≥4 岁患儿 IVIG 前绝对 CD19 B 细胞计数增加，且该增加与 IVIG 后白细胞介素 10（IL-10）减少呈线性相关（=0.71，<0.05）。患儿年龄越大，IVIG 对川崎病患儿免疫反应的调节作用越好，免疫平衡恢复越好。在≥4 岁的 KD 患儿中，异常增殖的 CD19 B 细胞可能参与 IL-10 的分泌以平衡体液免疫。在这些患者中，IVIG 前绝对 CD19 B 细胞计数和 IVIG 后 IL-10 降低水平的组合可能在评估 IVIG 对炎症的作用中发挥关键作用。
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