Kawasaki Syndrome (K.S.) is an acute vasculitis of childhood that results in coronary artery damage in 20% of patients. This complication is prevented by the early administration of gammaglobulin. Recently, we have demonstrated that during acute K.S. there is marked T cell and B cell activation in association with circulating cytotoxic IgM antibodies directed against gamma interferon (Gamma-INF) inducible antigens of vascular endothelial cells. The current proposal will test the hypothesis that a lymphocytotropic virus results in immunoregulatory abnormalities which trigger a cascade of events that result in tissue injury, particularly vasculitis. These events include the secretion of mediators (e.g., Gamma-IFN, IL-1, etc) which causes the expression of neoantigens on endothelial cells, and the production of cytotoxic antibodies to these neoantigens. Two related areas will be studied: First, we will assess the role of the immunoregulatory abnormalities in the pathogenesis of blood vessel injury in K.S. Specifically, we will: i) examine the presence and the target specificity of antibodies directed to endothelial cell antigens inducible by mediators of activated T cell and monocytes; ii) determine whether sera from acute K.S. are cytotoxic to other cell types activated with Gamma-IFN, IL-1 or other immune mediators; iii) examine the in vivo relevance of these findings by immunopathologic studies and by correlating the production of IL-1, Gamma-IFN and anti-endothelial cell antibodies with the clinical course, (fever, coronary artery disease) of K.S. patients treated with aspirin (ASA) alone or with ASA plus intravenousgGammaglobulin; iv) determine whether sera from other vasculitides (e.g., systemic lupus) contain antibodies directed against inducible endothelial cell antigens. Second, the possibility that K.S. is triggered by a lymphocytotropic virus will be explored by screening culture supernatants of K.S. peripheral blood lymphocytes (PBL) for reverse transcriptase and DNA polymerase activity by standard techniques. We will determine the divalent cation requirements, template and primer specificity, and transmissibility of the polymerase activity to establish T and/or B cell lines. Freshly isolated PBL and cultured PBL will be examined by electron microscopy for viral particles. It is hoped that these studies will contribute to a better understanding of the etiology and pathogenesis of K.S., provide a basis for more objective criteria for the diagnosis of this disease, and result in a more specific treatment of children with this potentially life-threatening disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL037260-02
Application #
3352795
Study Section
Pathology A Study Section (PTHA)
Project Start
1986-12-01
Project End
1991-11-30
Budget Start
1987-12-01
Budget End
1988-11-30
Support Year
2
Fiscal Year
1988
Total Cost
Indirect Cost
Name
Children's Hospital Boston
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115
Zhang, Yong; Leung, Donald Y M; Goleva, Elena (2014) Anti-inflammatory and corticosteroid-enhancing actions of vitamin D in monocytes of patients with steroid-resistant and those with steroid-sensitive asthma. J Allergy Clin Immunol 133:1744-52.e1
Goleva, Elena; Jackson, Leisa P; Harris, J Kirk et al. (2013) The effects of airway microbiome on corticosteroid responsiveness in asthma. Am J Respir Crit Care Med 188:1193-201
Zhang, Yong; Leung, Donald Y M; Goleva, Elena (2013) Vitamin D enhances glucocorticoid action in human monocytes: involvement of granulocyte-macrophage colony-stimulating factor and mediator complex subunit 14. J Biol Chem 288:14544-53
Goleva, Elena; Searing, Daniel A; Jackson, Leisa P et al. (2012) Steroid requirements and immune associations with vitamin D are stronger in children than adults with asthma. J Allergy Clin Immunol 129:1243-51
Goleva, Elena; Jackson, Leisa P; Gleason, Melanie et al. (2012) Usefulness of PBMCs to predict clinical response to corticosteroids in asthmatic patients. J Allergy Clin Immunol 129:687-693.e1
Zhang, Yong; Leung, Donald Y M; Richers, Brittany N et al. (2012) Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1. J Immunol 188:2127-35
Li, Ling-Bo; Leung, Donald Y M; Martin, Richard J et al. (2010) Inhibition of histone deacetylase 2 expression by elevated glucocorticoid receptor beta in steroid-resistant asthma. Am J Respir Crit Care Med 182:877-83
Searing, Daniel A; Zhang, Yong; Murphy, James R et al. (2010) Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid use. J Allergy Clin Immunol 125:995-1000
Goleva, Elena; Li, Ling-Bo; Leung, Donald Y M (2009) IFN-gamma reverses IL-2- and IL-4-mediated T-cell steroid resistance. Am J Respir Cell Mol Biol 40:223-30
Goleva, Elena; Hauk, Pia J; Hall, Clifton F et al. (2008) Corticosteroid-resistant asthma is associated with classical antimicrobial activation of airway macrophages. J Allergy Clin Immunol 122:550-9.e3

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