Immunological studies on Kawasaki disease. I. Appearance of Hanganutziu-Deicher antibodies.

Sera of patients with Kawasaki disease were studied for heterophile antibodies by means of enzyme immunoassay (EIA) with enzyme conjugated antisera to human IgM, IgG, IgA and IgE. Antibodies of IgM (43%), IgG (3%), IgA (11%) and IgE (49%) classes were demonstrated that combined with high molecular weight glycoprotein (HMWGP) of bovine red blood cells (BRBC) one of the antigenic preparations of the Hanganutziu-Deicher (H-D) heterophile system. Studies on sequential sera of the patients revealed that HMWGP antibodies of IgM and IgE classes began to appear in the second week, reached their peaks in the third week of the disease and declined gradually thereafter. Absorption studies on the positive sera showed that the HMWGP antibody activities were abolished by BRBC, sheep red blood cells and guinea-pig kidney tissues, confirming H-D specificity of these antibodies. EIA inhibition studies showed that the antibody activity was inhibited by HMWGP and partially by asialo-HMWGP and NGNA ganglioside rich preparation of BRBC but not by purified Paul-Bunnell or Forssman antigens. These results indicate that the H-D antibodies under investigation consist of antibodies of two different specificities; one directed against asialo-HMWGP and the other NGNA ganglioside of BRBC. Circulating immune complexes (IC) were demonstrated in 23% of the patients by means of anti-antibody inhibition test. Evidence was presented that IC in the sera of five patients were composed of H-D (HMWGP) antigen and its corresponding antibodies.