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Assessment of Antibody-based Drugs Effects on Murine Bone Marrow and Peritoneal Macrophage Activation
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Intravenous Immunoglobulin in Kawasaki Disease-Evolution and Pathogenic Mechanisms

Pallavi L Nadig1, Vibhu Joshi1, Rakesh Kumar Pilania1

  • 1Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.

Diagnostics (Basel, Switzerland)
|July 29, 2023
PubMed

Insights

Intravenous immunoglobulin (IVIg) effectively prevents coronary artery aneurysms in Kawasaki disease (KD). This review explores IVIg

Area of Science:

  • Pediatric rheumatology
  • Immunology
  • Vascular biology

Background:

  • Kawasaki disease (KD) is a childhood vasculitis impacting medium vessels, particularly coronary arteries.
  • Coronary artery aneurysms (CAAs) are a major complication, occurring in 25-30% of untreated cases.
  • Intravenous immunoglobulin (IVIg) reduces CAA risk to under 5%, but its immunomodulatory mechanisms are unclear.

Purpose of the Study:

  • To review the potential mechanisms of IVIg's immunomodulatory actions in Kawasaki disease.
  • To summarize evidence on IVIg infusion protocols and dosages for KD treatment.

Main Methods:

  • Review of existing literature on IVIg's effects in Kawasaki disease.
  • Analysis of studies investigating innate and adaptive immune system modulation by IVIg.
  • Examination of data on treatment protocols and dosages.

Main Results:

  • IVIg appears to modulate innate immunity via toll-like receptor pathways, autophagy, apoptosis, neutrophil extracellular traps, and dendritic cells.
  • IVIg also influences adaptive immunity by affecting T-cell differentiation, cytokine release, and regulatory T-cell function.
  • Evidence regarding various IVIg infusion protocols and dosages in KD treatment is summarized.

Conclusions:

  • IVIg exerts immunomodulatory effects on both innate and adaptive immune systems in Kawasaki disease.
  • Understanding these mechanisms can optimize KD treatment strategies and improve patient outcomes.
  • Further research is needed to fully elucidate IVIg's complex actions in KD.

Keywords:
Kawasaki diseaseadaptive immunitycoronary artery abnormalitiesinnate immunityintravenous immunoglobulinpathogenesistreatment

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