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Infliximab regulates monocytes and regulatory T cells in Kawasaki disease
Author(s) -
Koizumi Keiichi,
Hoshiai Minako,
Katsumata Nobuyuki,
Toda Takako,
Kise Hiroaki,
Hasebe Yohei,
Kono Yosuke,
Sunaga Yuto,
Yoshizawa Masashi,
Watanabe Atsushi,
Kagami Keiko,
Abe Masako,
Sugita Kanji
Publication year - 2018
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13555
Subject(s) - medicine , infliximab , flow cytometry , monocyte , tumor necrosis factor alpha , kawasaki disease , immunology , cytotoxic t cell , immune system , microbiology and biotechnology , in vitro , biology , biochemistry , artery
Background The effect of infliximab ( IFX ) on immune cells has not been fully reported in Kawasaki disease ( KD ). To investigate the mechanism of IFX in KD , we examined changes in the abundance of CD 14 + CD 16 + activated monocytes, regulatory T cells (T reg ) cells, and T‐helper type 17 (Th17) cells following treatment with IFX . Methods We collected peripheral blood from patients with i.v. immunoglobulin ( IVIG )‐resistant KD and analyzed absolute CD 14 + CD 16 + monocyte, T reg ( CD 4 + CD 25 + FOXP 3 + ) and Th17 cell ( CD 4 + IL ‐17A + ) counts on flow cytometry. We also measured changes in serum soluble interleukin ( IL )‐2 receptor ( IL ‐2R), IL ‐6, and tumor necrosis factor ( TNF )‐α on enzyme‐linked immunosorbent assay. Results T reg cells and Th17 cells significantly increased after IFX treatment compared with baseline (126 ± 85 cells/μL vs 62 ± 53 cells/μL, P < 0.01; 100 ± 111 cells/μL vs 28 ± 27 cells/μL, P < 0.05, respectively). In contrast, in a subgroup of patients with CD 14 + CD 16 + monocytes above the normal range before IFX , the CD 14 + CD 16 + monocytes significantly decreased following IFX treatment (72 ± 51 cells/μL vs 242 ± 156 cells/μL, P < 0.05).. Serum TNF ‐α did not change, but soluble IL ‐2R and IL ‐6 decreased after IFX treatment. Conclusion IFX could downregulate activated monocytes and upregulate T reg cells towards the normal range. IFX treatment thus contributes to the process of attenuating inflammation in KD .