Sho Hokibara1,2, Norimoto Kobayashi3, Keiko Kobayashi1, Tomonari Shigemura3, Haruo Nagumo4, Masahiro Takizawa5, Takashi Yamazaki6, Kazunaga Agematsu7. 1. Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, 390-8621, Japan. 2. Department of Pediatrics, Suwa Red Cross Hospital, Suwa, Japan. 3. Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan. 4. Department of Pediatrics, Shinshu Ueda Medical Center, Ueda, Japan. 5. Department of Pediatrics, Azumino Red Cross Hospital, Azumino, Japan. 6. Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan. 7. Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, 390-8621, Japan. nagematsu@nifty.com.
Abstract
OBJECTIVE: Kawasaki disease (KD) is the most commonly encountered inflammatory disease in children. However, its pathogenesis and diagnostic biomarkers have not been fully investigated. We examined the activation of neutrophils and monocytes in KD. METHODS: We studied the expression of the Fcγ-receptors CD64 and CD16 on neutrophils and monocytes in KD before and after the treatment with intravenous infusion of high dose immunoglobulin (IVIG). Bacterial infections were addressed as well. RESULTS: CD64 expression on neutrophils and monocytes was dramatically increased at the onset of KD flare-ups, but later decreased just after IVIG. Similarly, CD16-positive monocytes were observed at the onset and were less apparent after therapy. The addition of immunoglobulin did not block the expression of CD64 or CD16 in vitro. Serum G-CSF in the majority of patients, and IFN-γ in some patients, were elevated during flares but decreased after treatment. CONCLUSION: Our findings demonstrate that remarkable CD64 expression during KD flare-ups may serve as a biomarker for diagnosis. Evaluation of CD64 is also potentially useful for the determination of treatment efficacy in KD.
OBJECTIVE:Kawasaki disease (KD) is the most commonly encountered inflammatory disease in children. However, its pathogenesis and diagnostic biomarkers have not been fully investigated. We examined the activation of neutrophils and monocytes in KD. METHODS: We studied the expression of the Fcγ-receptors CD64 and CD16 on neutrophils and monocytes in KD before and after the treatment with intravenous infusion of high dose immunoglobulin (IVIG). Bacterial infections were addressed as well. RESULTS:CD64 expression on neutrophils and monocytes was dramatically increased at the onset of KD flare-ups, but later decreased just after IVIG. Similarly, CD16-positive monocytes were observed at the onset and were less apparent after therapy. The addition of immunoglobulin did not block the expression of CD64 or CD16 in vitro. Serum G-CSF in the majority of patients, and IFN-γ in some patients, were elevated during flares but decreased after treatment. CONCLUSION: Our findings demonstrate that remarkable CD64 expression during KD flare-ups may serve as a biomarker for diagnosis. Evaluation of CD64 is also potentially useful for the determination of treatment efficacy in KD.
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