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. 1995 Apr;72(4):308–311. doi: 10.1136/adc.72.4.308

Evidence for a superantigen mediated process in Kawasaki disease.

N Curtis 1, R Zheng 1, J R Lamb 1, M Levin 1
PMCID: PMC1511234  PMID: 7763061

Abstract

The clinical, pathological, and immunological similarities between Kawasaki disease and the staphylococcal and streptococcal toxic shock syndromes suggest that a superantigen toxin may be involved in the pathogenesis of the disease. The V beta repertoire of peripheral blood mononuclear cells from 21 children with Kawasaki disease, 28 children with other illnesses, and 22 healthy controls were examined using monoclonal antibodies to V beta 2, 5, 8, 12, and 19. The mean percentage of V beta 2 expressing T cells in the patients with Kawasaki disease was increased when compared with healthy controls or children with other illnesses. The mean percentages of V beta 5, 8, 12, and 19 expressing T cells were also increased in the patients with Kawasaki disease compared with healthy controls, but were not increased when compared with children with other illnesses. The selective use of V beta 2 supports the hypothesis that a superantigen is involved in the pathogenesis of Kawasaki disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abe J., Kotzin B. L., Jujo K., Melish M. E., Glode M. P., Kohsaka T., Leung D. Y. Selective expansion of T cells expressing T-cell receptor variable regions V beta 2 and V beta 8 in Kawasaki disease. Proc Natl Acad Sci U S A. 1992 May 1;89(9):4066–4070. doi: 10.1073/pnas.89.9.4066. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Abe J., Kotzin B. L., Meissner C., Melish M. E., Takahashi M., Fulton D., Romagne F., Malissen B., Leung D. Y. Characterization of T cell repertoire changes in acute Kawasaki disease. J Exp Med. 1993 Mar 1;177(3):791–796. doi: 10.1084/jem.177.3.791. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bell D. M., Morens D. M., Holman R. C., Hurwitz E. S., Hunter M. K. Kawasaki syndrome in the United States 1976 to 1980. Am J Dis Child. 1983 Mar;137(3):211–214. doi: 10.1001/archpedi.1983.02140290003001. [DOI] [PubMed] [Google Scholar]
  4. Burns J. C., Geha R. S., Schneeberger E. E., Newburger J. W., Rosen F. S., Glezen L. S., Huang A. S., Natale J., Leung D. Y. Polymerase activity in lymphocyte culture supernatants from patients with Kawasaki disease. 1986 Oct 30-Nov 5Nature. 323(6091):814–816. doi: 10.1038/323814a0. [DOI] [PubMed] [Google Scholar]
  5. Choi Y. W., Herman A., DiGiusto D., Wade T., Marrack P., Kappler J. Residues of the variable region of the T-cell-receptor beta-chain that interact with S. aureus toxin superantigens. Nature. 1990 Aug 2;346(6283):471–473. doi: 10.1038/346471a0. [DOI] [PubMed] [Google Scholar]
  6. Cone L. A., Woodard D. R., Schlievert P. M., Tomory G. S. Clinical and bacteriologic observations of a toxic shock-like syndrome due to Streptococcus pyogenes. N Engl J Med. 1987 Jul 16;317(3):146–149. doi: 10.1056/NEJM198707163170305. [DOI] [PubMed] [Google Scholar]
  7. Curtis N., Chan B., Levin M. Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome. Lancet. 1994 Jan 29;343(8892):299–299. [PubMed] [Google Scholar]
  8. Dhillon R., Newton L., Rudd P. T., Hall S. M. Management of Kawasaki disease in the British Isles. Arch Dis Child. 1993 Dec;69(6):631–638. doi: 10.1136/adc.69.6.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fujita Y., Nakamura Y., Sakata K., Hara N., Kobayashi M., Nagai M., Yanagawa H., Kawasaki T. Kawasaki disease in families. Pediatrics. 1989 Oct;84(4):666–669. [PubMed] [Google Scholar]
  10. Furusho K., Ohba T., Soeda T., Kimoto K., Okabe T., Hirota T. Possible role for mite antigen In Kawasaki disease. Lancet. 1981 Jul 25;2(8239):194–195. doi: 10.1016/s0140-6736(81)90370-6. [DOI] [PubMed] [Google Scholar]
  11. Hamashima Y., Kishi K., Tasaka K. Rickettsia-like bodies in infantile acute febrile mucocutaneous lymph-node syndrome. Lancet. 1973 Jul 7;2(7819):42–42. doi: 10.1016/s0140-6736(73)91975-2. [DOI] [PubMed] [Google Scholar]
  12. Hibberd M. L., Wong F. S., Nicholson L. B., Demaine A. G. Analysis of human T-cell receptor V beta gene usage following immunization to tetanus toxoid in vivo. Immunology. 1993 Jul;79(3):398–402. [PMC free article] [PubMed] [Google Scholar]
  13. Kato H., Fujimoto T., Inoue O., Kondo M., Koga Y., Yamamoto S., Shingu M., Tominaga K., Sasaguri Y. Variant strain of Propionibacterium acnes: a clue to the aetiology of Kawasaki disease. Lancet. 1983 Dec 17;2(8364):1383–1388. doi: 10.1016/s0140-6736(83)90921-2. [DOI] [PubMed] [Google Scholar]
  14. Kato H., Koike S., Yamamoto M., Ito Y., Yano E. Coronary aneurysms in infants and young children with acute febrile mucocutaneous lymph node syndrome. J Pediatr. 1975 Jun;86(6):892–898. doi: 10.1016/s0022-3476(75)80220-4. [DOI] [PubMed] [Google Scholar]
  15. Kawasaki T. [Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children]. Arerugi. 1967 Mar;16(3):178–222. [PubMed] [Google Scholar]
  16. Leung D. Y., Meissner H. C., Fulton D. R., Murray D. L., Kotzin B. L., Schlievert P. M. Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome. Lancet. 1993 Dec 4;342(8884):1385–1388. doi: 10.1016/0140-6736(93)92752-f. [DOI] [PubMed] [Google Scholar]
  17. Levin M., Tizard E. J., Dillon M. J. Kawasaki disease: recent advances. Arch Dis Child. 1991 Dec;66(12):1369–1372. doi: 10.1136/adc.66.12.1369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Marrack P., Kappler J. The staphylococcal enterotoxins and their relatives. Science. 1990 May 11;248(4956):705–711. doi: 10.1126/science.2185544. [DOI] [PubMed] [Google Scholar]
  19. Nakamura Y., Fujita Y., Nagai M., Yanagawa H., Imada Y., Okawa S., Kawasaki T., Kato H. Cardiac sequelae of Kawasaki disease in Japan: statistical analysis. Pediatrics. 1991 Dec;88(6):1144–1147. [PubMed] [Google Scholar]
  20. Nakamura Y., Yanagawa I., Kawasaki T. Temporal and geographical clustering of Kawasaki disease in Japan. Prog Clin Biol Res. 1987;250:19–32. [PubMed] [Google Scholar]
  21. Nigro G., Zerbini M., Krzysztofiak A., Gentilomi G., Porcaro M. A., Mango T., Musiani M. Active or recent parvovirus B19 infection in children with Kawasaki disease. Lancet. 1994 May 21;343(8908):1260–1261. doi: 10.1016/s0140-6736(94)92154-7. [DOI] [PubMed] [Google Scholar]
  22. Shackelford P. G., Strauss A. W. Kawasaki syndrome. N Engl J Med. 1991 Jun 6;324(23):1664–1666. doi: 10.1056/NEJM199106063242311. [DOI] [PubMed] [Google Scholar]
  23. Shulman S. T., Rowley A. H., Fresco R., Morrison D. C. The etiology of Kawasaki disease: retrovirus? Prog Clin Biol Res. 1987;250:117–124. [PubMed] [Google Scholar]
  24. Suzuki A., Tizard E. J., Gooch V., Dillon M. J., Haworth S. G. Kawasaki disease: echocardiographic features in 91 cases presenting in the United Kingdom. Arch Dis Child. 1990 Oct;65(10):1142–1146. doi: 10.1136/adc.65.10.1142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Tizard E. J., Suzuki A., Levin M., Dillon M. J. Clinical aspects of 100 patients with Kawasaki disease. Arch Dis Child. 1991 Feb;66(2):185–188. doi: 10.1136/adc.66.2.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Todd J., Fishaut M., Kapral F., Welch T. Toxic-shock syndrome associated with phage-group-I Staphylococci. Lancet. 1978 Nov 25;2(8100):1116–1118. doi: 10.1016/s0140-6736(78)92274-2. [DOI] [PubMed] [Google Scholar]
  27. Torres-Martínez C., Mehta D., Butt A., Levin M. Streptococcus associated toxic shock. Arch Dis Child. 1992 Jan;67(1):126–130. doi: 10.1136/adc.67.1.126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Yanagawa H., Nakamura Y., Kawasaki T., Shigematsu I. Nationwide epidemic of Kawasaki disease in Japan during winter of 1985-86. Lancet. 1986 Nov 15;2(8516):1138–1139. doi: 10.1016/s0140-6736(86)90541-6. [DOI] [PubMed] [Google Scholar]
  29. Yanagawa H., Nakamura Y., Yashiro M., Fujita Y., Nagai M., Kawasaki T., Aso S., Imada Y., Shigematsu I. A nationwide incidence survey of Kawasaki disease in 1985-1986 in Japan. J Infect Dis. 1988 Dec;158(6):1296–1301. doi: 10.1093/infdis/158.6.1296. [DOI] [PubMed] [Google Scholar]

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