Expression of Fc < gamma > Rs on monocytes among Kawasaki disease patients with coronary artery lesions

ObjectiveTo study expression of Fc gamma receptors (Fc < gamma > Rs) on monocytes in Kawasaki disease (KD) patients with coronary artery lesions (CAL).Methods160 newly diagnosed KD patients and 80 health children were enrolled in this study. All patients were scheduled to receive both aspirin and intravenous immunoglobulin (IVIG). Serial blood samples were obtained before and 3 days after completing IVIG therapy. The first two-dimensional echocardiographic examination was performed for all KD patients within 10 days, and was repeated at 3 weeks. CAL was defined by coronary artery Z-scores ≥ 2.5 by echocardiography. Expression of inhibitory and activating Fc < gamma > Rs on CD14+ monocytes (MCs) was assessed by flow cytometry. Cytokine expression in MC was evaluated by PCR.ResultsOf the 160 KD patients enrolled in this study, 36 had coronary artery lesions (KD-CAL+ group), while 124 did not (KD-CAL− group). There was no significant difference in Fc < gamma > RI expression on MCs from KD patients and that of Ctrls. Although Fc < gamma > RIII and Fc < gamma > RIIa levels were significantly higher in KD patients compared with those in Ctrls, there were no significant differences between the KD-CAL+ and KD-CAL− groups. Fc < gamma > RIIb expression in the KD patients was lower than that of Ctrls, meanwhile expression in the KD-CAL+ group was lower than that in the KD-CAL− group. After IVIG therapy, Fc < gamma > RIIb expression increased in KD-CAL+, but did not reach the normal range. A negative correlation was observed between the levels of IL-6, TNF-α and Fc < gamma > RIIb expression.ConclusionDecreased Fc < gamma > RIIb expression on MCs may contribute to the development of coronary artery lesions in patients with KD.