title: Reversal of lymphocyte activation in vivo in the Kawasaki syndrome by intravenous gammaglobulin.
abstract: The effect of intravenous gammaglobulin (IVGG) on the immunoregulatory abnormalities found during acute Kawasaki syndrome (KS) was studied in a randomized trial of IVGG plus aspirin (ASA) versus ASA alone. Before therapy, patients in each treatment group had increased numbers of circulating HLA-DR-bearing Leu 3+ helper T cells, a deficiency of Leu 2+ suppressor/cytotoxic T cells, and increased levels of spontaneous IgG and IgM synthesis by peripheral blood mononuclear cells. There were no significant differences (P greater than 0.1) between immunologic parameters measured on day 1 and day 4 in the ASA-treated group. In contrast, patients treated with ASA plus IVGG had by day 4 a highly significant decrease in HLA-Dr+ Leu 3+ helper T cells (P less than 0.001), an increase in Leu 2+ suppressor/cytotoxic T cells (P less than 0.01), and a decrease in spontaneous IgG (P less than 0.01) and IgM synthesis (P less than 0.001). These changes were associated with a reduction in the secretion of T cell-derived B cell helper factors (P less than 0.001). These findings indicate that treatment with IVGG suppresses the marked T and B cell activation found in patients with acute KS.
mesh_terms: D000911:Antibodies, Monoclonal; D001241:Aspirin / Q000627:therapeutic use*; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007262:Infusions, Intravenous; D008213:Lymphocyte Activation; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000276:immunology* / Q000628:therapy; D011897:Random Allocation; D012016:Reference Values; D013601:T-Lymphocytes / Q000145:classification / Q000276:immunology; D005719:gamma-Globulins / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D006684:HLA-DR Antigens; D005719:gamma-Globulins; D001241:Aspirin