Evidence for a superantigen mediated process in Kawasaki disease

Abstract

The clinical, pathological, and immunological similarities between Kawasaki disease and the staphylococcal and streptococcal toxic shock syndromes suggest that a superantigen toxin maybe involved in the pathogenesis of the disease. The Vβ 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 Vβ2, 5, 8, 12, and 19. The mean percentage ofVβ2 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 Vβ5, 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 Vβ2 supports the hypothesis that a superantigen is involved in the pathogenesis of Kawasaki disease.