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Effect of intravenous gamma-globulin on neutrophil function in Kawasaki disease
1Department of Pediatrics, Yamagata University School of Medicine, Japan.
Insights
Intravenous gamma-globulin (IVGG) effectively reduces neutrophil counts and activity in Kawasaki Disease (KD) patients. This suggests IVGG may mitigate vascular damage by decreasing active oxygen production during the early stages of KD.
Area of Science:
- Immunology
- Pediatrics
- Rheumatology
Background:
- Kawasaki Disease (KD) is an acute febrile illness affecting young children.
- Vascular damage in KD is thought to be mediated by neutrophil-derived active oxygen species.
- Intravenous gamma-globulin (IVGG) is a standard treatment for KD, but its precise mechanism of action requires further elucidation.
Purpose of the Study:
- To investigate the effect of IVGG on neutrophil count and neutrophil chemiluminescence (CL) in KD patients.
- To assess the dose-dependent effects of IVGG on neutrophil function.
- To explore the potential role of IVGG in reducing active oxygen production in KD.
Main Methods:
- A study involving 40 KD patients divided into three groups: GG 100 (100 mg/kg/day IVGG), GG 400 (400 mg/kg/day IVGG), and ASA (aspirin alone).
- Neutrophil counts and neutrophil chemiluminescence (CL) were measured at baseline and at specific intervals post-treatment.
- An in vitro study assessed the dose-dependent effect of gamma-globulin on neutrophil CL.
Main Results:
- Neutrophil counts were significantly lower in both IVGG groups (GG 100 and GG 400) compared to the aspirin-only group at three days, one week, and two weeks post-treatment.
- Neutrophil CL was significantly reduced in the IVGG groups compared to the aspirin-only group at one and two weeks post-treatment.
- In vitro, gamma-globulin demonstrated a dose-dependent suppressive effect on neutrophil CL, with albumin showing similar effects, indicating the suppression was not specific to gamma-globulin.
Conclusions:
- IVGG treatment leads to a significant reduction in neutrophil counts and activity in KD patients.
- The findings suggest that IVGG may exert its therapeutic effect by suppressing neutrophil-derived active oxygen production.
- This reduction in active oxygen species could be crucial in preventing or mitigating the vascular damage characteristic of early-stage Kawasaki Disease.
Abstract:
The effect of intravenous gamma-globulin (IVGG) on the neutrophil count and neutrophil chemiluminescence (CL) of patients with Kawasaki Disease (KD) was investigated. Forty patients with KD were enrolled in the study. Ten patients were treated with 100 mg/kg/day of gamma-globulin for five days (GG 100 group) and 14 patients were treated with 400 mg/kg/day of gamma-globulin (GG 400 group) for five days. These patients also took aspirin. Sixteen patients were treated with aspirin alone (ASA group). The neutrophil counts were significantly lower in the GG 400 and GG 100 groups than in the ASA group, three days, and one and two weeks after the start of treatment. Neutrophil CL of the GG 400 and GG 100 groups was significantly lower than in the ASA group one and two weeks after the start of treatment. In the in vitro study, gamma-globulin had a dose-dependent suppressive effect on the neutrophil CL in the early stage. Albumin had similar effects. The suppressive effect of gamma-globulin on CL was not specific. These findings suggest that IVGG is effective in reducing the production of active oxygen which is considered responsible for the vascular damage in the early stage of KD.