title: TCR V beta family repertoire and T cell activation markers in Kawasaki disease.
abstract: Kawasaki disease (KD) is the leading cause of acquired heart disease in children in the United States. The etiology is unknown. Data regarding the presence of T cell activation and its potential role in the pathogenesis of the disease have been conflicting. Expansion of T cells bearing V beta 2 and V beta 8 has recently been reported in the acute phase of KD, which suggests that a superantigen may mediate the disease process. To further assess the potential role of T cells in KD, T cell phenotypes were evaluated by using flow cytometry in a large series of patients, acutely and during convalescence. Included in this analysis were assessments of changes in the percentage of T cells bearing TCR V beta 2, V beta 5.1, V beta 6.7, V beta 8, V beta 12.1, and V beta 19 over time; the percentage of each V beta family bearing the activation markers HLA-DR and IL-2R; and the percentage of each V beta family bearing the memory marker, CD45RO. No expansion of any V beta family was present acutely, nor were increases in HLA-DR and IL-2R observed. However, a significant increase was observed during convalescence in the percentage of cells bearing CD45RO in the CD8+, but not the CD4+, population. CD45RO expression was also increased on V beta 2, V beta 8, and V beta 19 CD8+ T cells in a subset of patients. These data suggest that one or more conventional Ags drive the T cell immune response in KD, and argue against a role for superantigens in the disease process.
authors.affiliation: Division of Cardiology, Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH 45229.
authors.forename: B A
authors.initials: BA
authors.lastname: Pietra
authors.forename: J
authors.initials: J
authors.lastname: De Inocencio
authors.forename: E H
authors.initials: EH
authors.lastname: Giannini
authors.forename: R
authors.initials: R
authors.lastname: Hirsch
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016827:CD8 Antigens / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006801:Humans; D007223:Infant; D017493:Leukocyte Common Antigens / Q000378:metabolism; D008213:Lymphocyte Activation; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000276:immunology*; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000235:genetics*; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013997:Time Factors
chemical_list: D016827:CD8 Antigens; D016693:Receptors, Antigen, T-Cell, alpha-beta; D017493:Leukocyte Common Antigens