Increased Plasma Adrenomedulin Levels in Kawasaki Disease with Coronary Artery Involvement

Abstract

(Objective) Intravenous gamma globulin (IVGG) treatment is the most important therapy in the Kawasaki disease (KD), however there are many uncertainties about active mechanism of this treatment. This time, we examined active mechanisms of IVGG treatment affecting on apoptosis of neutrophils. (Patients and controls) Fifteen subjects (4 months ϳ 4 years old) were selected from the KD patients who had been admitted to Dokkyo University Hospital between June, 2000 and May, 2001. Healthy adults were used as controls.(Materials and methods) (1) Neutrophils were separated from heparinized blood by the specific gravity centrifugation. (2) Venoglobulin-I was used as human IgG for this experiment. (3) Apoptosis was determined with microscopic examination and flow cytometry. DNA quantity of the cells stained with PI alone and PI and anexin V was measured in flow cytometry.(Results) (1) Spontaneous apoptosis on KD patient neutrophils was more delayed than that on controls, as the picking illness day was earlier. (2) When healthy adult neutrophils was cultured in the presence of IgG (1mg/ml), apoptosis was promoted, but this effect was not observed under less than 0.1mg/ml IgG. Therefore, IgG was used at the concentration of 1mg/ml in further experiments. (3) The morphological changes unlike control neutrophils were observed on KD patient neutrophils after the culture in the presence of IgG. (4) Based on apoptosis pattern of neutrophils in the presence of IgG, samples were divided into two groups, promoted example and not. The promotion of apoptosis by the IgG addition in vitro was observed in about half of samples from the patients, in which IVGG gave more remarkable effects clinically. (Conclusions) We considered the possibility in which one part of the clinical effects of IVGG treatment had appeared by promoting the apoptotic effects to neutrophils.