title: Relationship between T-cell HLA-DR expression and intravenous immunoglobulin treatment response in Kawasaki disease.
abstract: BACKGROUND
  Kawasaki disease (KD) is an acute febrile illness associated with the development of vasculitis. Administration of intravenous immunoglobulin (IVIG) is the standard treatment for KD. However, IVIG treatment is not effective in approximately 15% of children with KD. Some reports have presented evidence of immunological responses in IVIG-resistant KD patients. We assessed the possibility that T-cell activation is a contributing mechanism underlying this phenomenon.
  
  
  METHODS
  We analyzed human leukocyte antigen-DR (HLA-DR) expression on peripheral blood CD4+ and CD8+ T cells in 82 children with KD who were admitted to the hospital between October 2007 and February 2012. We compared the percentages of HLA-DR+ T cells among the CD4+ T-cell and CD8+ T-cell populations for the IVIG-effective and IVIG-resistant groups.
  
  
  RESULTS
  Among the 82 subjects, 51 had IVIG-effective KD and 31 children had IVIG-resistant KD. The percentages of HLA-DR+ T cells among the CD4+ T-cell and CD8+ T-cell populations in the IVIG-effective group were significantly lower than those in the IVIG-resistant group.
  
  
  CONCLUSIONS
  Our results suggest that increased T-cell HLA-DR expression is associated with IVIG resistance in KD patients, indicating that HLA-DR expression would be a useful tool for predicting IVIG responsiveness during KD pathogenesis.
authors.affiliation: Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Wakiguchi
authors.affiliation: Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Hasegawa
authors.affiliation: Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Kudo
authors.affiliation: Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ichiyama
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005786:Gene Expression Regulation; D006684:HLA-DR Antigens / Q000378:metabolism*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D007963:Leukocytes, Mononuclear / Q000166:cytology; D008213:Lymphocyte Activation; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000276:immunology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D006684:HLA-DR Antigens; D016756:Immunoglobulins, Intravenous