Antibodies and Immunity During Kawasaki Disease

Abstract

The cause of Kawasaki disease (KD), the leading cause of acquired heart disease in children, is currently unknown. Epidemiology studies support that an infectious disease is involved in at least starting the inflammatory cascade set off during KD. Clues from epidemiology support that humoral immunity can have a protective effect. However, the role of the immune system, particularly of B cells and antibodies, in pathogenesis of KD is still unclear. Intravenous immunoglobulin (IVIG) and other therapies targeted at modulating inflammation can prevent development of coronary aneurysms. A number of autoantibody responses have been reported in children with KD and antibodies have been generated from aneurysmal plasma cell infiltrates. Recent reports show that children with KD have similar plasmablast responses as other children with infectious diseases, further supporting an infectious starting point. As ongoing studies are attempting to identify the etiology of KD through study of antibody responses, we sought to review the role of humoral immunity in KD pathogenesis, treatment, and recovery.

RETRACTED: Why are we vaccinating children against COVID-19?

“…The infection hypothesis is supported by epidemiology data showing that an infectious disease is involved at least as a starting point. Previously proposed infectious agents include Herpesviridae, retroviruses, Parvovirus B19, bocavirus, and bacterial infections such as staphylococci, streptococci, Bartonella, and Yersinia infections ( Hicar, 2020 ).…”

Multisystem Inflammatory Syndrome in Children (MIS-C), a Post-viral Myocarditis and Systemic Vasculitis—A Critical Review of Its Pathogenesis and Treatment

“…The role of specific immunity in KD is strongly supported by the evidence of an association with specific HLA genotypes that are likely to contribute to the differences in incidence between the Eastern and Western hemispheres (119); similar correlations are anticipated for MIS-C. Another important finding is the presence of IgA + oligoclonal plasma cells in the vascular wall (117) and immune complexes in the blood (120) among patients with KD, suggesting the involvement of antigens in the development of vasculitis seen in KD (121,122). The development of anti-cardiac myosin autoantibodies has been reported in cases that may have heart involvement in KD (97).…”

The up‐to‐date pathophysiology of Kawasaki disease

“…A difference in the expression levels of CD40/CD40 ligand (L) and B lymphoid tyrosine kinase (BLK) might affect the production rate and type of antibody produced in response to an external stimulus in patients with KD. These studies suggest that B cells and antibodies play a role in the pathogenesis of KD 96 . Furthermore, the difference might also influence oxidised LDL‐triggered CD40/CD40L signalling pathway in the endothelial cells to induce inflammation 97,98 .…”

“…These studies suggest that B cells and antibodies play a role in the pathogenesis of KD. 96 Furthermore, the difference might also influence oxidised LDL-triggered CD40/CD40L signalling pathway in the endothelial cells to induce inflammation. 97,98 In fact, CD40L expression on circulating cells is correlated with the occurrence of coronary artery lesions.…”