郭和昌醫師於2007 Nov-日本東京第3屆亞洲兒科醫學研究會議口頭報告內容(Kawasaki disease)-川崎病(川崎氏症)

Amy and me in Tokyo Japan 2007


Eosinophil-related T helper 2 (Th2) cytokines associated with the protection of coronary artery lesions in Kawasaki disease

Ho-Chang Kuo, MD1,2; Chih-Lu Wang, MD, PhD3; Chi-Di Liang, MD4;

Hong-Ren Yu, MD1,2; Chien-Fu Huang, MD4; Kao-Pin Hwang, MD, PhD5;

Kuender D. Yang, MD, PhD.1,2

Division of Allergy, Immunology and Rheumatology1; Division of Cardiology4 ; and Division of Infectious Disease5, Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan2; and Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan.3

ABSTRACT

OBJECTIVE: Kawasaki disease (KD) is a systemic febrile vasculitis especially coronary artery involvement. Eosinophilia has been found in our and other studies in KD. This study further investigates whether eosinophil-related T helper 2 (Th2) cytokines or the activation marker (eosinophil cationic protein, ECP) is involved in KD with coronary artery lesions ( CAL ).

PATIENTS AND METHODS: A total of 95 KD patients were enrolled for this study. Plasma samples were subjected to measurement of interleukin (IL)-4, IL-5 and eotaxin by Luminex-Bedalyte multiplex beadmates system and to measurement of ECP by fluoroimmunoassay. CAL was defined as internal diameter greater than 3 mm of coronary artery.

RESULTS: Patients with KD had higher eosinophils than controls. Eosinophil-related mediators: IL-4, IL-5, eotaxin and ECP levels were also higher in KD patients than controls before intravenous immunoglobulin (IVIG) treatment. After IVIG treatment, ECP decreased but IL-4, IL-5, and eotaxin increased significantly. The higher the IL-5 and eosinophil levels after IVIG treatment, the lower rate of CAL was found. Changes of eosinophils after IVIG treatment were positively correlated to changes of IL-5 levels.

CONCLUSIONS: The Th2 mediator (IL-5) but not ECP levels after IVIG treatment was associated with the protection of CAL formation.

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