THE
EFFECT OF INTRAVENOUS IMMUNOGLOBULIN ON INHIBITING PERIPHERAL BLOOD
LYMPHOCYTE APOPTOSIS IN ACUTE KAWASAKI DISEASE
Yi Qijian,
Li Chengrong and Yang Xiqiang
Children¡¯s Hospital, Chongqing
University of Medical Sciences, Chongqing, China
Objective: To further
explore the therapeutic mechanism of intravenous immunoglobulin (IVIG) for
Kawasaki disease (KD).
Methods: Peripheral
blood lymphocytes (PBLs) obtained from 26 children with KD and 20 age-matched
healthy children, were stimulated with anti-CD3 monoclonal antibody
(mAb),and apoptotic cell percentage and DNA fragmentation were assayed at
0,12,24,48,72 hours in vitro. The patients divided into 2 groups: One
treated with aspirin combined with IVIG (n=16) and another treated with aspirin
alone (n=10). PBLs were stimulated by phytohemagglutinin to evaluate
lymphocyte proliferative response.
Results: Compared
with normal controls, the apoptotic cell percentage and the DNA
fragmentation were markedly decreased (p<0.001) and delayed in PBLs from
KD patients. After IVIG treatment, the decreased percentage of apoptotic
cell and delayed DNA fragmentation were restored to the state of the normal
controls, accompanied by a fast clinical remission as compared to the Asp
alone group. The lymphocyte proliferative response was also decreased 3-5
days after IVIG therapy (p<0.001).
Conclusion: The results
suggested that decreased PBL apoptosis might be involved in the pathogenesis
of KD. The therapeutic mechanism of IVIG in KD may be partially due to the reversal
of the inhibited lymphocyte apoptosis, and may have implications for other
autoimmune diseases with inefficient lymphocyte apoptosis.