title: Evaluation of intravenous immunoglobulin resistance and coronary artery lesions in relation to Th1/Th2 cytokine profiles in patients with Kawasaki disease.
abstract: OBJECTIVE
  To investigate the roles of serum Th1 and Th2 cytokines in Kawasaki disease (KD) and determine whether the Th1/Th2 cytokine profiles in children with KD may be involved in intravenous immunoglobulin (IVIG) resistance and development of coronary artery lesions (CALs).
  
  
  METHODS
  Serum Th1 and Th2 cytokines, including interferon-γ (IFNγ), tumor necrosis factor α (TNFα), interleukin-10 (IL-10), IL-6, IL-4, and IL-2, were measured using a cytometric bead array in the serum of 143 patients with KD before and after treatment with IVIG (pre-IVIG, at 3 days after temperature normalization following IVIG treatment [post-IVIG], and 1 month posttreatment).
  
  
  RESULTS
  Levels of IL-6, IL-10, TNFα, and IFNγ were significantly increased in KD patients pre-IVIG. Post-IVIG, the levels of IL-6, IL-10, and IFNγ quickly decreased. The levels of TNFα decreased significantly after IVIG treatment in KD patients without CALs post-IVIG and in KD patients who were IVIG responders, but increased slightly in KD patients with CALs post-IVIG and in KD patients who were IVIG nonresponders. Before IVIG treatment, the levels of IL-4, IL-6, IL-10, and IFNγ were significantly higher in KD patients with CALs than in those without CALs. The post-IVIG levels of IL-6 and IL-10 were significantly higher in IVIG nonresponders than in IVIG responders. Pre-IVIG, an IL-10 level >8 pg/ml had a sensitivity of 75.0% and a specificity of 64.4% for predicting CALs, while a TNFα level <2 pg/ml had a sensitivity of 66.7% and a specificity of 74.2% for predicting IVIG resistance. Post-IVIG, an IL-6 level >10 pg/ml had a sensitivity of 67.9% and a specificity of 81.7% for predicting CALs, while an IL-10 level >6 pg/ml had a sensitivity of 53.6% and a specificity of 86% for predicting CALs.
  
  
  CONCLUSIONS
  Determination of the serum Th1/Th2 cytokine profile may be helpful for predicting the disease prognosis and targeting treatment strategies in patients with KD.
authors: Children's Hospital and Zhejiang University School of Medicine, Hangzhou, China.
authors: Yujia
authors: Y
authors: Wang
authors: Wei
authors: W
authors: Wang
authors: Fangqi
authors: F
authors: Gong
authors: Songling
authors: S
authors: Fu
authors: Qing
authors: Q
authors: Zhang
authors: Jian
authors: J
authors: Hu
authors: Yanqi
authors: Y
authors: Qi
authors: Chunhong
authors: C
authors: Xie
authors: Yiying
authors: Y
authors: Zhang
mesh_terms: D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D016207:Cytokines / Q000097:blood; D004351:Drug Resistance / Q000276:immunology; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000097:blood; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000188:drug therapy / Q000276:immunology; D018417:Th1 Cells / Q000378:metabolism / Q000473:pathology*; D018418:Th2 Cells / Q000378:metabolism / Q000473:pathology*
chemical_list: D016207:Cytokines; D016756:Immunoglobulins, Intravenous