Abstract
To date, Kawasaki disease (KD) has only been able to be diagnosed and evaluated using clinical characteristics. Additionally, the therapeutic effect and cardiovascular complications could not be verified until its occurrence. The present retrospective study analyzed the dynamic alterations of inflammatory cytokines, platelet (PLT) count, and subgroups of lymphocytes, such as cluster of differentiation (CD) 8+ T cells and CD19+ B cells, under different conditions in 64 children with KD. The percentage distribution of lymphocyte subgroups and the altered neutrophil lymphocyte ratio demonstrated that the inflammatory response was dominated by the B cell-mediated humoral immune response before intravenous immunoglobulin (IVIG) treatment, but mainly by T cells via cellular cytotoxic effects after IVIG treatment. Among the different types of inflammatory cytokines, the results of the present study revealed that the altered levels of interleukin-2 receptor (IL-2R) and interleukin-10 (IL-10) were closely associated with the percentage of CD8+ T cells and CD19+ B cells. Additionally, the two cytokines exhibited more sensitive fluctuations based on the status of the children with KD in various circumstances compared with other indexes, such as the percentages of CD8+ T cells and CD19+ B cells or the PLT count. These results suggested that children with KD who are ≥4 years old may benefit from IVIG but will not benefit from decreased platelet activation or suffer less cardiovascular complications. Additionally, starting clopidogrel usage earlier as an antiplatelet strategy should be considered based on the observed continuous rise in the PLT count in children with KD receiving IVIG. In conclusion, dynamically monitoring the levels of IL-2R and IL-10 has the potential to provide indications of the intensity and development of the inflammatory response in children with KD and may contribute to the early prediction and adjustment of pathological and pharmacological effects of therapy.
Highlights
Kawasaki disease (KD) was formally reported over 50 years ago
The neutrophil lymphocyte ratio (NLR) of all patients after intravenous immunoglobulin (IVIG) treatment fell within the normal range of values, which was
Prior to IVIG treatment, the percentage of cluster of differentiation (CD)19+ B cells in children with KD was markedly higher than the normal value, while that of CD8+ T cells was lower compared with the physiological value established by our hospital based on the data of healthy children (n ≥ 200)
Summary
Kawasaki disease (KD) was formally reported over 50 years ago. With the development of a therapeutic regimen, timely high-dose intravenous immunoglobulin (IVIG)usage in the acute phase, the mortality of KD has significantly declined. Kawasaki disease (KD) was formally reported over 50 years ago. 7.9% of patients still experience cardiovascular complications, including coronary dilation, valve lesions, coronary aneurysms, coronary stenosis, and acute myocardial infarction [1, 2]. Mediators of Inflammation children, and disease-related cardiovascular complications are the most common causes of acquired heart disease in children in developed countries as reported [1, 3]. With the accumulative experience and consciousness of KD, higher occurrences of coronary artery lesions in KD were reported than that of before. In China, cardiovascular complications of KD have gradually become the main cause of acquired heart disease. In both developed countries and developing countries including the United States, Japan, and China, cardiovascular complications from KD have been considered consistently to be the main cause of acquired heart disease [1, 3,4,5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
