title: Serum levels of interleukin-18 are elevated in the subacute phase of kawasaki syndrome.
abstract: BACKGROUND
  Elevations of various cytokines, including Th1 and Th2 cytokines, have been reported in the acute phase of Kawasaki syndrome (KS). As interleukin (IL)-18 plays an important role in the Th1 cell response, investigating the relevance of IL-18 in KS should be helpful in determining the pathophysiology of KS. Therefore, we examined the IL-18 values in KS.
  
  
  METHODS
  Serum IL-18 values were measured by an enzyme-linked immunosorbent assay. Samples were obtained from 41 patients in the acute and subacute phase of KS, 35 age-matched febrile controls and 13 afebrile controls.
  
  
  RESULTS
  No difference was observed in the values of white blood cell counts or C-reactive protein between acute-phase KS patients and febrile controls. On the contrary, acute-phase KS patients showed a significantly lower mean IL-18 value (398 +/- 206 pg/ml) than that of febrile controls (584 +/- 307 pg/ml) (p = 0.006). Subacute-phase KS patients showed a significantly elevated level of IL-18 (517 +/- 276 pg/ml) compared to acute-phase patients (p = 0.0008). The IL-18 values in the subacute-phase patients showed a significant positive correlation with the duration of fever (r = 0.427, p = 0.0055) and also with the presence of coronary artery abnormalities (r = 0.332, p = 0.0340). The incidence of elevated IL-18 values in the subacute-phase patients was significantly higher than that in the afebrile controls (p = 0.048).
  
  
  CONCLUSIONS
  Patients with KS showed normal IL-18 values in the acute phase and elevated values in the subacute phase. IL-18 pathways were activated in the subacute phase of KS, and subacute IL-18 values might be reflected in the severity of KS.
authors.affiliation: Department of Pediatrics, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan. uichi@m2.kufm.kagoshima-u.ac.jp
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nomura
authors.forename: Kiminori
authors.initials: K
authors.lastname: Masuda
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Maeno
authors.forename: Masao
authors.initials: M
authors.lastname: Yoshinaga
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawano
mesh_terms: D000208:Acute Disease; D002097:C-Reactive Protein / Q000378:metabolism; D003324:Coronary Artery Disease / Q000150:complications; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D020382:Interleukin-18 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000150:complications*
chemical_list: D020382:Interleukin-18; D002097:C-Reactive Protein