The Changes of Production of RANTES and Gro-alpha in Kawasaki Disease

ABSTRACT

PURPOSE: Kawasaki disease is probably driven by abnormalities of the immune system after infectious insult. In this report, a clinical review with laboratory parameters and the changes of the plasma levels of chemokines(RANTES and Gro-alpha was undertaken according to the clinical stage of Kawasaki disease. METHODS: This investigation included 74 samples from 21 patients(10 boys, 11 girls; mean age, 27.8 months) with Kawasaki disease who met the revised diagnostic guidelines and 5 samples from healthy children. The plasma levels of RANTES and Gro-alpha were measured by enzyme- linked immuno-sorbent assay(ELISA). To analyze the pattern of the gene expression of chemokine mRNA for lymphotactin(Ltn), RANTES, IP-10, MIP-1 beta, MIP-1 alpha MCP-1, IL-8 and I-309 in the peripheral blood monocyte, ribonuclease protection assays(RPA) were performed in 3 patients whose plasma levels of RANTES were very low and not significantly changed after intravenous immunoglobulin(IVIG) treatment. RESULTS: The production of RANTES and Gro-alpha were markedly elevated during the acute and subacute phases of Kawasaki disease compared to those of the normal control. In addition, interestingly, the changing patterns of plasma level of chemokines were not consistent(biphasic) after IVIG treatment. According to the RPA, the expression of RANTES was the most prominent among 8 kinds of chemokines and elevated in all phases of Kawasaki disease. But, there was no ovious relation between clinical characteristics of the disease including the coronary artery dilatation and the level of RANTES. CONCLUSION: These finding suggested that RANTES and Gro-alpha may play an important role in pathophysiology of the Kawasaki disease. Longer follow-up and more case studies will be needed to clearly establish the significance of the changes of RANTES and Gro-alpha in the pathophysiology of Kawasaki disease.