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Published on: September 15, 2017
Evaluation of the cytokine response in Kawasaki disease
B A Eberhard1, U Andersson, R M Laxer
1Division of Rheumatology, Hospital For Sick Children, Toronto, Canada.
Insights
This study found that intracellular cytokines, including tumor necrosis factor (TNF)-alpha and TNF-beta, are present in patients with Kawasaki disease during the acute phase. These cytokines, along with interleukin-6, indicate activated immune cells contribute to the disease.
Area of Science:
- Immunology
- Pediatric Infectious Diseases
Background:
- Kawasaki disease is an acute febrile illness affecting young children.
- The role of intracellular cytokines in the pathogenesis of Kawasaki disease remains incompletely understood.
Purpose of the Study:
- To investigate the presence and dynamics of intracellular cytokines, specifically interleukin-6 (IL-6), tumor necrosis factor (TNF)-alpha, and TNF-beta, in patients with Kawasaki disease.
- To determine the association of these cytokines with disease stages and immune cell types.
Main Methods:
- Peripheral blood mononuclear cells (PBMCs) from patients at acute, subacute, and convalescent stages of Kawasaki disease were analyzed.
- Cytokine detection was performed using cytokine-specific monoclonal antibodies and indirect immunofluorescence.
- Immune cell populations (monocytes and lymphocytes) were assessed for intracellular cytokine expression.
Main Results:
- Intracellular TNF-alpha and TNF-beta were detected exclusively during the acute stage of Kawasaki disease, prior to therapy.
- Intracellular IL-6 was observed in the acute stage and in a subset of patients during the subacute stage.
- Approximately 60% of patients (15 of 25) exhibited at least one intracellular cytokine.
- In the acute phase, TNF-alpha and TNF-beta were found in 58% of patients' PBMCs, while IL-6 was present in 16%.
Conclusions:
- Activated mononuclear cells, including T cells and monocytes, and their secreted cytokines are implicated in the pathogenesis of Kawasaki disease.
- The temporal expression pattern of intracellular cytokines suggests a role in the acute inflammatory processes of the disease.
Abstract:
Intracellular cytokines interleukin 6, tumor necrosis factor (TNF) alpha and TNF-beta were studied in peripheral blood mononuclear cells of patients with Kawasaki disease during the acute, subacute and convalescent stages of the disease utilizing cytokine-specific monoclonal antibodies and indirect immunofluorescence. Intracellular cytokines TNF-alpha and -beta were present only during the acute stage before initiation of therapy and not in the subacute or convalescent phase. Intracellular interleukin 6 was seen in both the acute phase and, in small numbers of patients, in the subacute stage of the illness. Overall 15 of 25 (60%) patients produced at least one intracellular cytokine. In the acute stage both monocyte and lymphocyte cytokines were detected intracellularly, TNF-alpha and TNF-beta in 58% of patients whereas interleukin 6 was seen in only 16%. This study provides evidence to support the involvement of activated mononuclear cells, both T cells and monocytes and their secreted soluble products, cytokines, in the pathogenesis of Kawasaki disease.
