PMID- 32812215
OWN - NLM
STAT- MEDLINE
DCOM- 20210518
LR  - 20221108
IS  - 1365-2249 (Electronic)
IS  - 0009-9104 (Print)
IS  - 0009-9104 (Linking)
VI  - 202
IP  - 3
DP  - 2020 Dec
TI  - Characterization of circulating immune cells in acute Kawasaki disease suggests 
      exposure to different antigens.
PG  - 263-272
LID - 10.1111/cei.13506 [doi]
AB  - Kawasaki disease (KD) is an acute pediatric vasculitis of unknown etiology that 
      can cause coronary artery aneurysms, and is the leading cause of acquired heart 
      disease in children. We studied aspects of the innate and adaptive immune 
      response in 17 acute KD children prior to treatment with intravenous 
      immunoglobulin. Distinct patterns within the innate immune response correlated 
      with specific clinical features. Proinflammatory myeloid dendritic cells (mDC) 
      were abundant in four of 17 (23.5%) subjects who were older and manifested severe 
      inflammation with clinical myocarditis and elevated hepatobiliary enzyme levels. 
      Of the nine subjects with low levels of anti-inflammatory, tolerogenic mDC, six 
      had enlarged cervical lymph nodes at diagnosis. In contrast, the adaptive immune 
      repertoire varied greatly with no discernible patterns or associations with 
      clinical features. Two subjects with aneurysms had numerous circulating CD8(+) T 
      cells. Ten subjects showed low CD4(+) T cell numbers and seven subjects had 
      CD4(+) T cells in the normal range. CD4(+) T cells expressed interleukin-7 
      receptor (IL-7R), suggesting repeated antigenic stimulation. Thymic-derived 
      regulatory T cells (nT(reg) ) and peripherally induced regulatory T cells 
      (iT(reg) ) were also enumerated, with the majority having the nT(reg) phenotype. 
      Natural killer (NK) and NK T cell numbers were similar across all subjects. Taken 
      together, the results of the immune monitoring suggest that KD may have multiple 
      triggers that stimulate different arms of the innate and adaptive compartment in 
      KD patients. Thus, it is possible that diverse antigens may participate in the 
      pathogenesis of KD.
CI  - (c) 2020 The Authors. Clinical & Experimental Immunology published by John Wiley & 
      Sons Ltd on behalf of British Society for Immunology.
FAU - Burns, J C
AU  - Burns JC
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Hsieh, L E
AU  - Hsieh LE
AUID- ORCID: 0000-0003-1179-2229
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Kumar, J
AU  - Kumar J
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Behnamfar, N
AU  - Behnamfar N
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Shimizu, C
AU  - Shimizu C
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Sivilay, N
AU  - Sivilay N
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Tremoulet, A H
AU  - Tremoulet AH
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
FAU - Franco, A
AU  - Franco A
AD  - School of Medicine, Department of Pediatrics, University of California San Diego, 
      La Jolla, CA, USA.
LA  - eng
GR  - R01 AI143586/AI/NIAID NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200827
PL  - England
TA  - Clin Exp Immunol
JT  - Clinical and experimental immunology
JID - 0057202
RN  - 0 (Antigens)
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Acute Disease
MH  - Antigens/*blood/immunology
MH  - Child
MH  - Child, Preschool
MH  - Dendritic Cells/immunology/*metabolism
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage
MH  - Infant
MH  - Lymphocytes/immunology/*metabolism
MH  - Male
MH  - Mucocutaneous Lymph Node Syndrome/*blood/drug therapy
PMC - PMC7670149
OTO - NOTNLM
OT  - acute pediatric vasculitis
OT  - antigenic triggers
OT  - immune monitoring
COIS- None of the authors have financial or commercial conflicts of interest.
EDAT- 2020/08/20 06:00
MHDA- 2021/05/19 06:00
PMCR- 2020/08/27
CRDT- 2020/08/20 06:00
PHST- 2020/04/13 00:00 [received]
PHST- 2020/08/03 00:00 [revised]
PHST- 2020/08/04 00:00 [accepted]
PHST- 2020/08/20 06:00 [pubmed]
PHST- 2021/05/19 06:00 [medline]
PHST- 2020/08/20 06:00 [entrez]
PHST- 2020/08/27 00:00 [pmc-release]
AID - CEI13506 [pii]
AID - 10.1111/cei.13506 [doi]
PST - ppublish
SO  - Clin Exp Immunol. 2020 Dec;202(3):263-272. doi: 10.1111/cei.13506. Epub 2020 Aug 
      27.