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2015 ; 48
(3
): 181-8
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Fine specificities of natural regulatory T cells after IVIG therapy in patients
with Kawasaki disease
#MMPMID25822882
Burns JC
; Touma R
; Song Y
; Padilla RL
; Tremoulet AH
; Sidney J
; Sette A
; Franco A
Autoimmunity
2015[May]; 48
(3
): 181-8
PMID25822882
show ga
The activation of natural regulatory T cells (nTreg) recognizing the heavy
constant region (Fc) of IgG is an important mechanism of action of intravenous
immunoglobulin (IVIG) therapy in Kawasaki disease (KD). Lack of circulating
Fc-specific nTreg in the sub-acute phase of KD is correlated with the development
of coronary artery abnormalities (CAA). Here, we characterize the fine
specificity of nTreg in sub-acute (2- to 8-week post-IVIG) and convalescent (1-
to 10-year post-IVIG) KD subjects by testing the immunogenicity of 64 peptides,
15 amino acids in length with a 10 amino acid-overlap spanning the entire Fc
protein. About 12 Fc peptides (6 pools of 2 consecutive peptides) were recognized
by nTreg in the cohorts studied, including two patients with CAA. To test whether
IVIG expands the same nTreg populations that maintain vascular homeostasis in
healthy subjects, we compared these results with results obtained in healthy
adult controls. Similar nTreg fine specificities were observed in KD patients
after IVIG and in healthy donors. These results suggest that T cell fitness
rather than T cell clonal deletion or anergy is responsible for the lack of
Fc-specific nTreg in KD patients who develop CAA. Furthermore, we found that
adolescents and adults who had KD during childhood without developing CAA did not
respond to the Fc protein in vitro, suggesting that the nTreg response induced by
IVIG in KD patients is short-lived. Our results support the concept that peptide
epitopes may be a viable therapeutic approach to expand Fc-specific nTreg and
more effectively prevent CAA in KD patients.
|*Convalescence
[MESH]
|Acute Disease
[MESH]
|Adolescent
[MESH]
|Adult
[MESH]
|Amino Acid Sequence
[MESH]
|Case-Control Studies
[MESH]
|Child
[MESH]
|Coronary Artery Disease/immunology/pathology/*prevention & control
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Immunoglobulin Fc Fragments/chemistry/genetics/*immunology
[MESH]
|Immunoglobulins, Intravenous/*therapeutic use
[MESH]