| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Immunology, Vol 159, Issue 12 5946-5955, Copyright © 1997 by American Association of Immunologists
ARTICLES |
AH Rowley, CA Eckerley, HM Jack, ST Shulman and SC Baker
Department of Pediatrics, The Ronald McDonald Children's Hospital, Maywood, IL 60153, USA. arowley@wpo.it.luc.edu
The etiology and pathogenesis of Kawasaki syndrome (KS) remain unknown. Clinical and epidemiologic features of KS are consistent with an infectious cause. To search for an etiologic agent of KS, a phage cDNA expression library was constructed from the aorto-iliac junction of a patient with fatal acute KS and screened with convalescent KS serum followed by anti-human Ig. Unexpectedly, 0.1% of the clones in the library react with anti-human Ig, indicating the presence of many Ig- producing B lymphocytes in the vasculitic tissue. To confirm this finding and to determine the isotypes produced, frozen vascular tissue sections from the patient and paraffin sections from coronary arteries from six additional patients with fatal acute or subacute KS were incubated with Abs to Ig isotypes. Histopathology of the tissues revealed the presence of many plasma cells in the inflammatory infiltrate. IgA was the predominant isotype produced in vascular tissue in all seven KS patients. IgM- and IgG-producing cells were less often detected. We conclude that there is a marked plasma cell response within the vasculitic tissue in KS, with unusual IgA production locally in this nonlymphoid, nonmucosal tissue. We suggest that the prominence of IgA plasma cells in the vascular infiltrate in the early, acute, and subacute stages of KS indicates an Ag-driven immune response to an etiologic agent with a respiratory or gastrointestinal portal of entry and speculate that this unusual immune response is integral to the pathogenesis of the illness.
This article has been cited by other articles:
|
|
 |
|
  R.-E. W. Kavey, V. Allada, S. R. Daniels, L. L. Hayman, B. W. McCrindle, J. W. Newburger, R. S. Parekh, and J. Steinberger Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics Circulation, December 12, 2006; 114(24): 2710 - 2738. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kobayashi, Y. Inoue, K. Takeuchi, Y. Okada, K. Tamura, T. Tomomasa, T. Kobayashi, and A. Morikawa Prediction of Intravenous Immunoglobulin Unresponsiveness in Patients With Kawasaki Disease Circulation, June 6, 2006; 113(22): 2606 - 2612. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Rowley, S. T. Shulman, F. L. Garcia, J. A. Guzman-Cottrill, M. Miura, H. L. Lee, and S. C. Baker Cloning the Arterial IgA Antibody Response during Acute Kawasaki Disease J. Immunol., December 15, 2005; 175(12): 8386 - 8391. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Newburger, M. Takahashi, M. A. Gerber, M. H. Gewitz, L. Y. Tani, J. C. Burns, S. T. Shulman, A. F. Bolger, P. Ferrieri, R. S. Baltimore, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association Pediatrics, December 1, 2004; 114(6): 1708 - 1733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Newburger, M. Takahashi, M. A. Gerber, M. H. Gewitz, L. Y. Tani, J. C. Burns, S. T. Shulman, A. F. Bolger, P. Ferrieri, R. S. Baltimore, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association Circulation, October 26, 2004; 110(17): 2747 - 2771. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Barbaro, G. Di Lorenzo, and G. Barbarini Kawasaki-like syndrome in an HIV-infected adult Rheumatology, November 1, 2003; 42(11): 1427 - 1429. [Full Text] [PDF]
|
|
|
|
|
|
H. C. Meissner and D. Y. M. Leung Kawasaki Syndrome: Where Are the Answers? Pediatrics, September 1, 2003; 112(3): 672 - 676. [Full Text] [PDF]
|
|
|
|
 |
|
 S. T. Shulman Severe, Complicated Kawasaki Disease Treated With Corticosteroids AAP Grand Rounds, February 1, 2001; 5(2): 11 - 11. [Full Text] [PDF]
|
|
|
|
|
|
A. H. Rowley, S. T. Shulman, B. T. Spike, C. A. Mask, and S. C. Baker Oligoclonal IgA Response in the Vascular Wall in Acute Kawasaki Disease J. Immunol., January 15, 2001; 166(2): 1334 - 1343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Burns, H. I. Kushner, J. F. Bastian, H. Shike, C. Shimizu, T. Matsubara, and C. L. Turner Kawasaki Disease: A Brief History Pediatrics, August 1, 2000; 106(2): 27e - 27. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. W Newburger and J. C Burns Kawasaki disease Vascular Medicine, August 1, 1999; 4(3): 187 - 202. [Abstract] [PDF]
|
|
|
|
 |
|
 A. H. Rowley and S. T. Shulman Kawasaki Syndrome Clin. Microbiol. Rev., July 1, 1998; 11(3): 405 - 414. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
