Reduced frequencies of peripheral interferon-gamma-producing CD4+ and CD4- cells during acute Kawasaki disease

This study was performed to analyze the frequencies of peripheral interferon (IFN)-gamma-producing cells at the single-cell level and to determine concentrations of circulating IFN-gamma in the acute and subacute phases of Kawasaki disease (KD).

Ten patients with KD were studied and seven healthy children were selected as control subjects. Using immunofluorescent detection of intracellular IFN-gamma in CD4-positive and CD4-negative cells, the frequencies of IFN-gamma-producing cells in peripheral blood mononuclear cells were studied. Circulating IFN-gamma levels were measured by enzyme-linked immunosorbent assay.

The frequencies of peripheral blood CD4+ and CD4- IFN-gamma-producing cells in acute-phase KD patients were significantly lower than in subacute-phase KD patients and control children (p < 0.05). CD4- cells, thought to be mainly composed of CD8+ cells, appeared to be more responsible for the reduced frequencies of total IFN-gamma-producing cells than CD4+ cells. There were, however, no differences in the frequencies of IFN-gamma-producing cells between KD patients in the subacute phase and control children. In contrast, serum IFN-gamma levels were higher in KD patients in the acute phase than in the subacute phase (p < 0.05).

The above results show increased levels of circulating IFN-gamma and decreased emergence of peripheral IFN-gamma-producing cells in acute KD patients, suggesting transient infiltration of activated IFN-gamma-producing cells into the inflammatory sites during acute KD. These findings also support the hypothesis that IFN-gamma plays an important role in the pathogenesis of KD-related vasculitis.