Immunoglobulin profiling identifies unique signatures in patients with Kawasaki disease during intravenous immunoglobulin treatment

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Abstract

Identifying the causes of high fever syndromes such as Kawasaki disease (KD) remains challenging. To investigate pathogen exposure signatures in suspected pathogen-mediated diseases such as KD, we performed immunoglobulin (Ig) profiling using a next-generation sequencingmethod. After intravenous Ig (IVIG) treatment, we observed disappearance of clonally expanded IgMclonotypes, which were dominantly observed in acute-phase patients. The complementary-determining region 3 (CDR3) sequences of dominant IgM clonotypes in acute-phase patients were commonly observed in other Ig isotypes. In acute-phase KD patients, we identified 32 unique IgM CDR3 clonotypes shared in three ormore cases. Furthermore, before the IVIG treatment, the sums of dominant IgMclonotypes in IVIG-resistant KD patients were significantly higher than those of IVIG-sensitive KD patients. Collectively, we demonstrate a novel approach for identifying certain Ig clonotypes for potentially interacting with pathogens involved in KD; this approach could be applied for a wide variety of fever-causing diseases of unknown origin.

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Ko, T. M., Kiyotani, K., Chang, J. S., Park, J. H., Yew, P. Y., Chen, Y. T., … Nakamura, Y. (2018). Immunoglobulin profiling identifies unique signatures in patients with Kawasaki disease during intravenous immunoglobulin treatment. Human Molecular Genetics, 27(15), 2671–2677. https://doi.org/10.1093/hmg/ddy176

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