Study On Changes And The Roles Of T-cell Subsets, SICAM-1 And VEGF In The Acute Phase Of KD In Children

Objective: Kawasaki disease (KD) is an acute self-limited vasculitis that predominantly affects infants and young children ,and has become the leading cause of acquired heart disease in children. Majority patients with KD are characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities. Coronary artery aneurysms or ectasia develop in minority patients and may lead to sudden death. Timely diagnosis and therapy substantially reduce the incidence and severity of coronary involvement in KD. Although the pathogenesis of KD remains unknown, the great progress has been made in recent years in elucidating the etiology and the pathology involved in the coronary arterial abnormalities of KD. Characteristics of KD are acute vasculitis and systemic immune activation. The study had explored the possible roles of the cellular immune function, sICAM-1 and VEGF in the pathogenesis of KD by detecting T-cell subsets, sICAM-1 and VEGF in the acute phase of KD.Methods: T-cell subsets were detected by Freeze-dried sensitized erythrocyte rosette methods, and the levels of sICAM-1 and VEGF were detected by ELISA methods in 48 acute KD patients and 45 nomal children. Using SPSS10.0 software to assay the data. Results were expressed as mean±SD. Continuous data were analyzed with t-test. P<0.05 was considered statistically significant. All cases hadn't been treated with IVIG and hormone before collecting blood.Results:1. During the acute stage of KD, the percentage CD4+ and the ratio CD4+/CD8+ increased markedly, wlile the percentage of CD8+ decreased significantly compared with the controls(P<0.05).2. The serum levels of sICAM-1 in the acute stage of KD patients were elevated in comparison to nomal chileren (P<0.05).3. The content of serum VEGF in children with KD was significitantly higher at the acute stage of KD than that of the nomal control group (P<0.01).Conclusion:1. There was markedly immune regulation disorder in acute stage of KD, which was mostly feature by extensive immune activation and T-cell subsets disorder. As a result,it hinted that it would be better to treat with immunomodulator than immunosuppressant only.2. The study documented that the content of serum sICAM-1 and VEGF in the acute stage of KD was significtantly higher than that of the control group.We suggested that the two cytokines may play important roles in the process of vasculitis of acute KD.