Soluble CD2 levels in serum during acute Kawasaki disease and infectious mononucleosis.
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Acute Disease↗
Biomedical subjects
K Yabuta
Publications and source records attributed to K Yabuta.
Transient depletion of T cells with bright CD11a/CD18 expression from peripheral circulation during acute Kawasaki disease.
To clarify the activation of peripheral blood T cells in Kawasaki disease (KD) patients, we investigated whether expression of lymphocyte function-associated antigen-1 (LFA-1, CD11a/CD18) and/or intercellular adhesion molecule-1 (ICAM-1, CD54) on peripheral blood T cells increases during the acute stage. Expression of cellular adhesion molecules was measured using flow cytometry. There was a decrease in the percentage of CD3+ T cells in the bright LFA-1 alpha and LFA-1 beta population and a concomitant increase in the dim population of LFA-1 alpha and LFA-1 beta during the acute stage, in comparison with those of the convalescent stage. In addition, we observed no significant differences in ICAM-1 expression during the acute stage compared with that of the convalescent stage. In our view the present data, in conjunction with previous reports on T-cell function during acute KD, suggest that activated T cells are temporarily withdrawn from peripheral circulation during acute KD.
Acute Disease↗
Pathologic and laboratory dynamics following the removal of the shunt in shunt nephritis.
Membranoproliferative glomerulonephritis (type 1) associated with infected ventriculoatrial shunt was observed in an 11-year-old girl. The removal of the shunt and antimicrobial therapy led to rapid improvement in the clinical symptoms, serologic abnormalities, and glomerular alterations. Serum complement levels were initially low and returned to normal values within 1 month. Urinary sediment abnormalities resolved within a few months. Cultures taken from cerebrospinal fluid and the end of the shunt grew Staphylococcus epidermidis. Initial renal biopsy obtained immediately before shunt removal showed membranoproliferative glomerulonephritis (type 1). Repeat biopsy performed 2 years after shunt removal showed moderate improvement of glomerular alterations. This study of pathologic and laboratory changes following therapy suggests that the pathophysiology of the nephritis was based on an immunologic process, and that removal of antigen resulted in reversal of glomerular changes.
Biopsy↗
Decreased expression of CD23 on peripheral blood macrophages/monocytes during acute Kawasaki disease with coronary artery lesions.
CD23 has been reported to be a macrophage/monocyte activation antigen. We focused on the expression of CD23 by peripheral blood macrophages/monocytes in 5 Kawasaki disease (KD) patients with coronary artery lesions (CAL) and compared these values with those of 35 patients without CAL. The expression of CD23 on peripheral blood macrophages/monocytes was assayed by a fluorescence-activated cell sorter using monoclonal antibodies CD23 and CD14. Absolute counts of CD23+CD14+ macrophages/monocytes in KD patients with CAL did not increase during the acute stage, while these values in KD patients without CAL increased. In addition, this decreased expression of CD23 on peripheral blood macrophages/monocytes in patients with CAL did not change during the acute stage, regardless of IVGG therapy. Our results suggest that the decreased expression of CD23 on peripheral blood macrophages/monocytes in patients with CAL is part of the regulatory system of CD23 antigen during acute KD.
Acute Disease↗
Immunohistochemical studies on small intestinal mucosa in Kawasaki disease.
To investigate the etiology of Kawasaki disease (KD), the cell surface phenotypes of mononuclear cells and enterocytes in the jejunal mucosa of KD were investigated in a case-control study. Sixteen Japanese patients with KD were enrolled in the study. As disease controls, jejunal tissues from 10 patients with diarrhea due to cow's milk protein intolerance were used. The numbers of cells stained by an immunofluorescent technique were counted and analyzed statistically by t test. Both HLA-DR+CD3+ and DR+CD4+ cells were significantly increased in the lamina propria of KD patients in the acute phase compared with numbers in controls and patients with cow's milk protein intolerance (p < or = 0.01). CD8+ cells were significantly reduced in both the epithelium and the lamina propria of KD patients in the acute phase in comparison with numbers in both controls (p < or = 0.05) and patients with cow's milk protein intolerance (p < or = 0.01). HLA-DR+ cells were significantly increased in both the enterocytes and the lamina propria of KD patients in the acute phase compared with numbers in controls (p < or = 0.01). These cell patterns returned to normal in the convalescent phase of KD. Differences between these cell patterns in KD patients with and without diarrhea were not significant, although these immunohistochemical features tended to be more marked in patients with diarrhea than in those who lacked diarrhea. These results are consistent with what one would expect to find if a delayed-type hypersensitivity reaction had occurred in the small intestinal mucosa of KD patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Antigens, CD↗
Soluble ICAM-1 levels in serum during acute infectious mononucleosis.
Intercellular adhesion molecule-1 (ICAM-1) has been reported as a T-cell, B-cell or macrophage/monocyte activation antigen. We investigated whether soluble ICAM-1 levels in serum increased during the acute stage in 11 patients with infectious mononucleosis (IM). Serum ICAM-1 levels were measured by a double determinant immunoassay using 2 monoclonal antibodies in the FAST system. Serum ICAM-1 levels in patients with IM increased during the acute stage. There was a positive correlation between serum ICAM-1 levels and absolute counts of peripheral blood mononuclear cells. Our results suggest that the elevated serum ICAM-1 levels are based on the increased counts of activated peripheral blood mononuclear cells and that ICAM-1 is a part of the regulatory system of immune reactions during acute IM.
Acute Disease↗
Increase in T cells expressing the gamma/delta receptor and CD4+CD8+ double-positive T cells in primary immunodeficiency complicated by human T-cell lymphotropic virus type I infection.
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CD4 Antigens↗
Increased levels of circulating intercellular adhesion molecule 1 in Kawasaki disease.
OBJECTIVE: We investigated whether levels of intercellular adhesion molecule 1 (ICAM-1) antigen shed into the circulation increase during acute Kawasaki disease (KD). We also compared ICAM-1 levels in acute KD with those in anaphylactoid purpura (AP) and in measles. METHODS: Serum ICAM-1 levels were measured by a double-determinant immunoassay using 2 monoclonal antibodies in the FAST (Falcon assay screening test) system. Serum levels of tumor necrosis factor alpha (TNF alpha) were measured by a specific and sensitive sandwich enzyme immunoassay. RESULTS: Patients with KD, but not those with AP or measles, had increased levels of shed ICAM-1 antigen in serum samples obtained during acute stages. Moreover, during the acute stage, KD patients with coronary artery lesions (CAL) had still higher levels of shed ICAM-1 than did those without CAL. We found a positive correlation between serum levels of shed ICAM-1 and levels of TNF alpha during acute KD. CONCLUSION: Our findings suggest that the serum ICAM-1 level is an important immunologic parameter for determining the severity of vascular damage during acute KD.
Cell Adhesion Molecules↗
Central diabetes insipidus in hypoxic brain damage.
We describe two children who after cardiopulmonary arrest developed hypernatremia at the terminal stage. Urinary antidiuretic hormone concentration was very low, indicating central diabetes insipidus. These cases illustrate the necessity of alertness to the development of central diabetes insipidus in patients with severe hypoxic brain damage.
Adolescent↗
Pseudohyperkalaemia in Kawasaki disease.
Pseudohyperkalaemia was observed in 3 of 16 patients with Kawasaki disease showing remarkably increased platelet counts. Their plasma potassium concentration, which is not affected by in vitro coagulation, was in the normal range despite the increased serum level. A significant correlation was observed between the platelet count and the increase in the serum potassium level resulting from blood coagulation, which was estimated by subtracting the plasma potassium level from the serum level. This study indicates that pseudohyperkalaemia should be considered in patients with Kawasaki disease whose platelet counts are markedly increased.
Child, Preschool↗
Plasma endothelin concentration: relation with vascular resistance and comparison before and after balloon dilatation procedures.
Endothelin (ET) is a potent vasoconstrictor peptide with an as yet uncertain physiological role in cardiovascular disease. We measured blood plasma ET concentrations using a recently developed radioimmunoassay and analysed the relations between ET concentration, systemic arterial pressure and systemic vascular resistance. In addition, ET levels before and after percutaneous balloon valvuloplasty and angioplasty were measured. Fifty-one patients were studied: (1) 13 patients with small left-to-right shunting or Kawasaki heart disease (age ranged from 4 to 144 months); (2) 10 patients who had undergone balloon valvuloplasty or angioplasty (age ranged from 1 to 233 months) and (3) 28 healthy infants and children (age ranged from 3 to 152 months). Systemic vascular resistance was calculated by the formula (mean aortic pressure--mean right atrial pressure) X 80/cardiac output (dyne.sec.cm-5). Plasma ET concentrations in healthy children less than 2 years were significantly higher than those over 2 years (2.48 +/- 0.62 vs 1.31 +/- 0.53 pg/ml). In eight patients in groups 1 and 2, plasma ET concentration in the pulmonary artery (2.00 +/- 0.43 pg/ml) was significantly lower than that in the femoral vein (2.39 +/- 0.69 pg/ml) and aorta (2.23 +/- 0.59 pg/ml), suggesting ET secretion derived from endothelial cells in peripheral pulmonary vessels. There was a significant positive correlation between ET concentrations in the femoral vein and systemic vascular resistance (r = 0.55, p less than 0.05). After balloon dilatation ET concentration rose from 2.15 +/- 0.82 pg/ml to 2.61 +/- 1.38 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Kawasaki disease differs from anaphylactoid purpura and measles with regard to tumour necrosis factor-alpha and interleukin 6 in serum.
It has been reported that tumour necrosis factor-alpha (TNF-alpha) is capable of inducing vascular injury, and interleukin 6 (IL-6) of inducing production of acute phase proteins and the maturation of megakaryocytes. Kawasaki disease (KD) is a systemic vasculitis with severe inflammation. We investigated whether TNF-alpha and IL-6 activities in serum from patients with KD differs from those in anaphylactoid purpura (AP) and measles. Serum TNF-alpha levels were measured by a sandwich enzyme immunoassay and IL-6 activities in serum were assessed by a colorimetric assay. Both KD and AP patients but not patients with measles had increased serum TNF-alpha levels during the acute stage. With respect to IL-6, patients with KD and measles, but not AP, had increased IL-6 activities in serum during the acute stage. IL-6 activities in serum of KD patients correlated with serum C-reactive protein levels and correlated to some extent with maximum platelet counts during the course of illness. These results suggest that KD differs from AP and measles regarding both cytokines. The combination of TNF-alpha, which may be responsible for severe vascular injury, and IL-6, which may be responsible for severe inflammation, may play an important role in acute KD.
C-Reactive Protein↗
Tumor necrosis factor-alpha inhibitory activity in urine of Kawasaki disease.
Recently it has been reported that naturally occurring inhibitors of tumor necrosis factor alpha (TNF-alpha) were demonstrated in urine of some acute febrile patients. We investigated whether TNF-alpha inhibitory activity in urine increases during acute Kawasaki disease (KD). TNF-alpha inhibitory activities in urine were measured by a cytotoxicity assay on the TNF-susceptible cell line L929. KD patients had increased TNF-alpha inhibitory activities in urine during the acute stage and returned to a normal range during the convalescent stage. Our results suggest that the TNF-alpha inhibitor in urine is part of the regulatory system of TNF-alpha, which might be responsible for vascular injury during acute KD.
Child, Preschool↗
Glomerular alterations in children with biliary atresia.
To investigate the association of glomerular involvement with biliary atresia, we carried out the following studies: (1) review of the clinical records of 120 patients, (2) histologic study of the kidneys obtained at autopsy from 28 patients, and (3) measurements of circulating immune complexes. Of 90 patients with adequate follow-up information, 40 (44.4%) had hematuria, proteinuria, or both. All the kidney specimens showed a wide variety of mesangial proliferation, and immunoglobulins were present in 23 of 26 cases. There was a good correlation between the glomerular alterations and the period of reduced hepatic function. When IgA was present in the mesangium, IgA2 and secretory components were detected. Elevated serum IgA and circulating IgA-containing immune complex levels were found in patients with prolonged obstructive jaundice. These findings indicate that glomerular alterations may occur subsequently in patients with biliary atresia, and that IgA of intestinal mucosal origin plays some role in the development of these lesions.
Antigen-Antibody Complex↗
Renal abnormalities associated with Williams syndrome.
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Abnormalities, Multiple↗
Increased expression of CD23 on peripheral blood B cells and macrophages/monocytes during acute infectious mononucleosis.
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Antigens, CD↗
1 beta-hydroxylated bile acids in the urine of healthy neonates.
In order to clarify the metabolism of bile acids in neonates, 1 beta-hydroxylated bile acids in the urine of healthy newborns were examined by gas chromatography-mass spectrometry. The results showed that the percentage of total 1 beta-hydroxylated bile acids, 3 beta, 12 alpha-dihydroxy-5-cholenoic acid and hyocholic acid in neonates was significantly higher than in older children. The ratio of 1 beta-hydroxylated bile acids to their comparable primary bile acids was also higher in neonates than in older children. These results suggest that 1 beta- and 6 alpha-hydroxylation of bile acids are the predominant pathways of bile acid metabolism in neonates.
Bile Acids and Salts↗
IgE levels in faecal extracts of patients with food allergy.
IgE levels in faecal extracts (Copro-IgE levels) were investigated in food allergy (FA) patients before and after the challenge test administration of food allergens. IgE levels were measured by time-resolved fluoroimmunometric assay. In addition, the effects of administration of oral sodium cromoglycate (SCG) on the Copro-IgE levels were studied. Copro-IgE levels in patients with FA, who were placed on an elimination diet, did not differ from those of healthy children. After a challenge test immediate symptoms of urticaria and wheezing were observed in all FA patients. Copro-IgE levels in each patient increased markedly within 24 h of the challenge test. Moreover, FA patients treated orally with SCG showed neither the increase in Copro-IgE levels nor any remarkable symptoms after the challenge. Our results suggest that the increased Copro-IgE levels may be a specific consequence of the local immune response to food allergen stimulation in the gut mucosa.
Allergens↗