Abstract
It has been reported that tumour necrosis factor-α (TNF-α) is capable of inducing vascular injury, and interleukin 6 (IL-6) of inducing production of acute phase proteins and the maturation of megakaryocytes. Kawasaki disease (KD) is a systemic vasculitis with severe inflammation. We investigated whether TNF-α and IL-6 activities in serum from patients with KD differs from those in anaphylactoid purpura (AP) and measles. Serum TNF-α levels were measured by a sandwich enzyme immunoassay and IL-6 activities in serum were assessed by a colourimetric assay. Both KD and AP patients but not patients with measles had increased serum TNF-α levels during the acute stage. With respect to IL-6, patients with KD and measles, but not AP, had increased IL-6 activities in serum during the acute stage. IL-6 activities in serum of KD patients correlated with serum C-reactive protein levels and correlated to some extent with maximum platelet counts during the course of illness. These results suggest that KD differs from AP and measles regarding both cytokines. The combination of TNF-α, which may be responsible for severe vascular injury, and IL-6, which may be responsible for severe inflammation, may play an important role in acute KD.
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Abbreviations
- AP:
-
anaphylactoid purpura
- CAL:
-
coronaryartery lesion
- GRP:
-
C-reactive protein
- IFN-γ:
-
gamma interferon
- IL:
-
interleukin
- IL-2R:
-
interleukin 2 receptor
- KD:
-
Kawasaki disease
- TNF:
-
tumour necrosis factor
References
Bevilacqua MP, Pober JS, Majeau GR, Fiers W, Cortran RS, Gimbrone MA Jr (1986) Recombinant tumor necrosis factor induces procoagulant activity in cultured human vascular endothelium: characterization and comparison with the actions of interleukin 1. Proc Natl Acad Sci USA 83:4533–4537
Fujiwara H, Hamashima Y (1978) Pathology of the heart in Kawasaki disease. Pediatrics 61:100–107
Furukawa S, Matsubara T, Jujoh K, Yone K, Sugawara T, Sasai K, Kato H, Yabuta K (1988) Peripheral blood monocyte/macrophages and serum tumor necrosis factor in Kawasaki disease. Clin Immunol Immunopathol 48:247–251
Furukawa S, Matsubara T, Sasai K, Yabuta K (1989) Serum levels of cytokines in Kawasaki disease. In: Kawasaki T (ed) The Third International Kawasaki Disease Symposium, Proceedings, Japan Heart Foundation, Tokyo, Japan, pp 132–134
Ganldie J, Richards C, Harnish D, Lansdorp D, Banmann H (1987) Interferon β2/B-cell stimulatory factor type 2 shares identity with monocyte-derived hepatocyte-stimulating factor and regulate the major acute phase protein response in liver cells. Proc Natl Acad Sci USA 84:7251–7255
Hirose S, Hamashima Y (1978) Morphological observations on the vasculitis in the mucocutaneous lymph node syndrome. Eur J Pediatr 129:17–27
Ishibashi T, Kimura H, Uchida T, Kariyone S, Friese P, Burstein SA (1989) Human interleukin 6 is a direct promotor of maturation of megakaryocytes in vitro. Proc Natl Acad Sci USA 86:5953–5957
Kawasaki T (1967) Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes: clinical observations of 50 cases. Jpn J Allergol 16:178–222 (in Japanese)
Kawasaki T, Kosaki F, Osawa S, Shigematsu I, Yanagawa S (1974) A new infantile acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 54:271–276
Leung DYM, Geha RS, Newburger JW, Burns J, Fiers W, Lapierre LA, Pober JS (1986) Two monokines, interleukin 1 and tumor necrosis factor, render cultured vascular endothelial cells susceptible to lysis by antibodies circulating during Kawasaki syndrome. J Exp Med 164:1958–1972
Matsubara T, Furukawa S, Yabuta K (1990) Serum levels of tumor necrosis factor, interleukin 2 receptor and gamma interferon in Kawasaki disease involved coronary-artery lesion. Clin Immunol Immunopathol 56:29–36
Matsuda T, Hirano T, Kishimato T (1988) Establishment of an interleukin 6 (IL6)/B cell stimulatory factor 2-dependent cell line and preparation of anti-IL 6 monoclonal antibodies. Eur J Immunol 18:951–956
Maury CPJ, Salo E, Pelkonen P (1988) Circulating interleukin-1β in patients with Kawasaki disease. N Engl J Med 319:1670–1671
Maury CPJ, Salo E, Pelkonen P (1989) Elevated circulating tumor necrosis factor-α in patients with Kawasaki disease. J Lab Clin Med 113:651–654
Nawroth PP, Stern DM (1986) Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 163:740–745
Pober JS, Bevilacqua MP, Mendrick DL, Lapierre LA, Fiers W, Gimbrone MA Jr (1986) Two distinct monokines, interleukin 1 and tumor necrosis factor each independantly induce biosynthesis and transient expression of the surface of cultured human vascular endothelial cells. J Immunol 136:1680–1687
Research Committee on Kawasaki disease (1984) Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Ministry of Health and Welfare, Tokyo, pp 56–66
Ueno Y, Takano N, Kanegane H, Yokoi T, Yachie A, Miyawaki T, Taniguchi N (1989) The acute phase nature of interleukin 6: studies in Kawasaki disease and other febrile illnesses. Clin Exp Immunol 76:337–342
Yone K, Hashida S, Ichikawa E, Tanaka K (1990) Specific and sensitive sandwich enzyme immunoassay for human tumor necrosis factor-α. Clin Chem Enzym Comms 3:1–8
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Furukawa, S., Matsubara, T., Yone, K. et al. Kawasaki disease differs from anaphylactoid purpura and measles with regard to tumour necrosis factor-α and interleukin 6 in serum. Eur J Pediatr 151, 44–47 (1992). https://doi.org/10.1007/BF02073890
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DOI: https://doi.org/10.1007/BF02073890