The Effect of Intravenous Immunoglobulin on Inhibiting Peripheral Blood Lymphocyte Apoptosis in Acute Kawasaki Disease

Aim: To further explore the therapeutic mechanism of intravenous immunoglobulin(IVIG) for Kawasaki disease(KD). Method: Peripheral blood lymphocytes(PBLs) obtained from 26 children with KD and 20 age matched healthy children, were stimulated with anti-CD3 monoclonal antibody(mAb),and apoptotic cell percentage and DNA fragmentation were assayed at 0,12,24,48,72 hours in vitro. The patients belonged to 2 groups: One treated with aspirin combined with IVIG(n=16) and one treated with aspirin alone(n=10).PBLs were stimulated by phytohemagglutinin(PHA) to evaluate lymphocyte proliferative response. Results: Compared with normal controls, the apoptotic cell percentage and the DNA fragmentation were markedly decreased(p<0.001) and delayed in PBLs from KD patients. After IVIG treatment, the decreased percentage of apoptotic cell and delayed DNA fragmentation were restored to the state of the normal controls, accompanied by a fast clinical remission as compared to the Asp alone group. The lymphocyte proliferative response was also decreased 3-5 days after IVIG therapy (p<0.001). Conclusion: The results suggested that decreased PBL apoptosis might be involved in the pathogenesis of KD. The therapeutic mechanism of IVIG in KD may be partially due to the reversal of the inhibited lymphocyte apoptosis, and may have implications for other autoimmune diseases with inefficient lymphocyte apoptosis.