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Title of Journal: Eur J Pediatr

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Abbravation: European Journal of Pediatrics

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Springer-Verlag

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DOI

10.1002/micr.1920130404

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1432-1076

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Lack of CD4Superscript+/SuperscriptCD25Supers

Authors: Yu Hirabayashi Yoshiyuki Takahashi Yinyan Xu Kazuyuki Akane Itzel Bustos Villalobos Yusuke Okuno Shinji Hasegawa Hideki Muramatsu Asahito Hama Taichi Kato Seiji Kojima
Publish Date: 2013/01/23
Volume: 172, Issue: 6, Pages: 833-837
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Abstract

The aim of this study was to investigate changes in CD4+CD25+FOXP3+ regulatory T cells Tregs throughout the clinical course of Kawasaki disease KD and correlations with response to intravenous immunoglobulin IVIg therapy Participants comprised 18 patients who fulfilled the diagnostic criteria for KD and 20 healthy subjects Expressions of CD25 and FOXP3 among all CD4+ T cells in peripheral blood mononuclear cells were analyzed by flow cytometry before and 7 and 30 days after IVIg therapy Before treatment percentages of CD4+CD25+FOXP3+ Tregs among total CD4+ Tregs were significantly lower among KD patients 419  range 016–811  than among healthy subjects 732  418–1342  P = 00001 Both percentages and absolute numbers of CD4+CD25+FOXP3+ Tregs on day 7 after IVIg therapy were significantly increased compared with values before treatment 802  range 051–126  vs 419  range 016–811  P = 00005 9325/ μL range 667–25805 vs 4185/ μL range 044–16062 P  00001 respectively Moreover percentages and absolute numbers of CD4+CD25+FOXP3+ Tregs before treatment were significantly lower in the IVIgresistant group than in the IVIgsensitive group 018  range 016–334  vs 452  range 28–811  P = 00022 068/μL range 044–5381 vs 5166/μL range 288–16062 P = 00098 respectively The frequency of CD4+CD25+FOXP3+ Tregs in four of the five IVIgresistant patients at diagnosis was more than 3 standard deviations below that in healthy subjects Two of these four patients displayed coronary abnormalities and one of these two patients developed coronary aneurysm Conclusion Lack of CD4+CD25+FOXP3+ Tregs before treatment may predict resistance to IVIg therapy in patients with KD

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