Cytoplasmic inclusion bodies are detected by synthetic antibody in ciliated bronchial epithelium during acute Kawasaki disease.
BACKGROUND
In developed nations, Kawasaki disease (KD) is the most common cause of acquired heart disease in children. An infectious etiology is likely but has not yet been identified. We have previously reported that oligoclonal immunoglobulin A plasma cells infiltrate acute KD tissues and that synthetic KD antibodies detect a distinctive spheroidal antigen in acute KD ciliated bronchial epithelium.


METHODS
To further characterize the antigen in acute KD bronchi, we examined paraffin-embedded ciliated bronchial epithelium using light microscopy (LM) and transmission electron microscopy (TEM).


RESULTS
The spheroids observed by immunohistochemistry (IHC) are visualized as inclusion bodies with hematoxylin-eosin and nucleic acid stains and in methylene blue/azure II/basic fuchsin trichrome-stained plastic sections, suggesting the presence of both protein and nucleic acid. The structures visualized by LM correspond to homogeneous electron-dense perinuclear inclusion bodies (up to 1.4 microns in diameter) in ciliated bronchial epithelium from 4 patients with acute KD examined by TEM. Inclusion bodies were not present in control bronchial epithelium or in nonciliated cells.


CONCLUSIONS
The antigen detected in acute KD ciliated bronchial epithelium by IHC with synthetic KD antibodies resides in cytoplasmic inclusion bodies that are consistent with aggregates of viral proteins and associated nucleic acid and may derive from the etiologic agent of KD.
Rowley
Anne H
AH
Department of Pediatrics, Feinberg School of Medicine, Children's Memorial Hospital, Northwestern University, Chicago, IL 60611, USA. a-rowley@northwestern.edu
Baker
Susan C
SC
Shulman
Stanford T
ST
Fox
Linda M
LM
Takahashi
Kei
K
Garcia
Francesca L
FL
Crawford
Susan E
SE
Chou
Pauline
P
Orenstein
Jan M
JM
D000911:Antibodies, Monoclonal / Q000276:immunology*; D001980:Bronchi / Q000166:cytology* / Q000648:ultrastructure; D002675:Child, Preschool; D003593:Cytoplasm / Q000648:ultrastructure; D004848:Epithelium / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D002479:Inclusion Bodies / Q000276:immunology / Q000648:ultrastructure*; D007223:Infant; D008297:Male; D046529:Microscopy, Electron, Transmission; D009080:Mucocutaneous Lymph Node Syndrome / Q000209:etiology*
D000911:Antibodies, Monoclonal