Abstract
The effects of intravenous gammaglobulin (IVGG) on changes in the peripheral blood mononuclear cell subsets during acute Kawasaki disease (KD) were studied by a random selection trial of IVGG plus Aspirin (group G) compared to Aspirin alone (group A). Group G received IVGG with 200 mg/kg per day × 5 dose. The absolute counts of peripheral blood mononuclear cell subsets were assayed by a fluorescence-activated cell sorter using monoclonal antibodies of Leu series. Before therapy, patients in each treatment group had increased counts of CD14+ macrophage/monocytes compared to healthy childhood controls (P<0.01). After IVGG treatment, group G underwent a greater decrease in their CD14+ macrophage/monocyte counts (P<0.01) than group A. The changes of CD3+ T cells, Leu 7+ NK/K cells and CD19+ B cells in the peripheral blood mononuclear cell subsets with treatment in group G, were similar to those in group A. These results suggest the possibility that IVGG therapy is effective in KD by modulating macrophages/monocytes.
Similar content being viewed by others
Abbreviations
- CAL:
-
coronary-artery lesions
- IL:
-
interleukin
- IVGG:
-
intravenous gammaglobulin
- KD:
-
Kawasaki disease
- TNF:
-
tumour necrosis factor
References
Abo T, Balch CM (1981) A differentiation antigen of human NK and K cells indentified by a monoclonal antibody (HNK-1). J Immunol 127:1024–1029
Dimitriu-Bona A, Burmester GR, Waters SJ, Winchester RJ (1983) Human mononuclear phagocyte differentiation antigens. 1. Patterns of antigenic expression on the surface if human monocytes and macrophages defined by monoclonal antibodies. J Immunol 130:145–152
Engleman EG, Benike CJ, Glickman E, Evans RL (1981) Antibodies to membrane structures that distinguish suppressor/cytotoxic and helper T lymphocyte subpopulations block the mixed leukocyte reaction in man. J Exp Med 153:193–198
Evans RL, Wall DW, Platsoucas CD, Siegal FP, Fikrig SM, Testa CM, Good RA (1981) Thymus-dependent membrane antigens in man: inhibition of cell-mediated lympholysis by monoclonal antibodies to TH2 antigen. Proc Natl Acad Sci USA 78:544–548
Fujiwara H, Hamashima Y (1978) Pathology of the heart in Kawasaki's disease. Pediatrics 61:100–107
Furukawa S, Matsubara T, Jujoh K, Yone K, Sugawara T, Sasai K, Kato H, Yabuta K (1988) Peripheral blood monocyte/macrophage and serum tumor necrosis factor in Kawasaki disease. Clin Immunol Immunopathol 48:247–251
Furukawa S, Matsubara, T, Sasai K, Yabuta K (1989) Serum levels of cytokines in Kawasaki disease. In: Kawasaki T (ed) The third international Kawasaki disease symposium, proceedings. Japan Heart Foundation, Tokyo, Japan, pp 132–134
Furusho K, Kamiya T, Nakano H, Kiyosawa N, Shinomiya K, Hayashida T, Tamura T, Hirose O, Manabe Y, Yokoyama T, Kawarano M, Baba K, Baba K, Mori C (1984) High-dose intravenous gammaglobulin for Kawasaki disease. Lancet II:1055–1058
Hirose S, Hamashima Y (1978) Morphological observations on the vasculitis in the mucocutaneous lymph node syndrome. A skin biopsy study of 27 patients. Eur J Pediatr 129:17–27
Kawasaki T (1967) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes: Clinical observations of 50 cases. Jpn J Allergol 16:178–222 (in Japanese)
Kawasaki T (1985) Comment on new diagnostic guideline of Kawasaki disease. Pediatr Jpn 26:985–993 (in Japanese)
Kawasaki T, Kosaki F, Osawa S, Shigematsu I, Yanagawa S (1974) A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 54: 271–276
Kyogoku M (1987) A pathological analysis of Kawasaki disease: with some suggestions its etio-pathogenesis. In: Schulman ST (ed) Kawasaki disease. Alan R. Liss, New York, pp 257–273
Ledbetter JA, Evans RL, Lipinski M, Cunningham-Rundles C, Good RA, Herzenberg LA (1981) Evolutionary conservation of surface molecules that distinguish T lymphocyte helper/inducer and cytotoxic/suppressor subpopulation in mouse and man. J Exp Med 153:310–323
Leung DYM, Geha RS, Newburger JW, Burns J, Fiers W, Lapierre LA, Pober JS (1986) Two monokines, interleukin 1 and tumor necrosis factor, render cultured vascular endothelial cells susceptible to lysis by antibodies circulating during Kawasaki syndrome. J Exp Med 164:1958–1972
Leung DYM, Burns JC, Newburger JW, Geha RS (1987) Reversal of lymphocyte activation in vivo in the Kawasaki syndrome by intravenous gammaglobulin. J Clin Invest 79:468–472
Meeker TC, Miller RA, Link MP, Bindl J, Warnke R, Levy R (1984) A unique human B lymphocyte antigen defined by a monoclonal antibody. Hybridoma 3:305–320
Nawroth PP, Stern DM (1986) Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 163:740–745
Newburger JW, Takahashi M, Burns JC, Beiser A, Chung KJ, Duffy E, Glose MP, Mason WH, Reddy V, Sanders SP, Shulman ST, Wiggins JW, Hicks RV, Fulton DR, Lewis AB, Leung DYM, Colton T, Rosen FS, Melish ME (1986) Treatment of Kawasaki syndrome with intravenous gammaglobulin. N Engl J Med 315:341–346
Pober JS, Bevilacqua MP, Mendrick DL, Lapierre LA, Fiers W, Gimbrone MA Jr (1986) Two distinct monokines, interleukin 1 and tumor necrosis factor, each independently induce biosynthesis and transient expression of the same antigen on the surface of culture human vascular endothelial cells. J Immunol 136:1680–1687
Research Committee on Kawasaki Disease (1984) Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Ministry of Health and Welfare, Tokyo, Japan, pp 56–66
Research Committee on Kawasaki Disease (1986) Report on research concerning Kawasaki disease. Ministry of Health and Welfare, Tokyo, Japan, pp 105–112 (in Japanese)
Rowley AH, Duffy CE, Shulman ST (1988) Prevention of giant coronary artery aneurysms in Kawasaki disease by intravenous gamma globulin therapy. J Pediatr 113:290–294
Sugawara T, Hattori S, Hirose S, Furukawa S, Yabuta K, Shirai T (1987) Immunopathology of the skin lesions of Kawasaki disease. In: Schulman ST (ed) Kawasaki disease. Alan R. Liss, New York, pp 185–192
Suzuki M, Kaneda Y, Tsuda M, Lee T, Fukuda Y, Furukawa S, Ishige H, Sugimoto H (1983) High-dose intravenous gammaglobulin therapy for Kawasaki disease. Pediatr Jpn 24:391–395 (in Japanese)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Furukawa, S., Matsubara, T., Jujoh, K. et al. Reduction of peripheral blood macrophages/monocytes in Kawasaki disease by intravenous gammaglobulin. Eur J Pediatr 150, 43–47 (1990). https://doi.org/10.1007/BF01959479
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01959479