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    Innate immune responses following Kawasaki disease and toxic shock syndrome

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    Author
    Chen, KYH; Messina, N; Germano, S; Bonnici, R; Freyne, B; Cheung, M; Goldsmith, G; Kollmann, TR; Levin, M; Burgner, D; ...
    Date
    2018-02-15
    Source Title
    PLoS One
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Curtis, Richard; Messina, Nicole; Cheung, Michael; Burgner, David; Freyne, Bridget; Chen, Katherine
    Affiliation
    Paediatrics (RCH)
    Metadata
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    Document Type
    Journal Article
    Citations
    Chen, K. Y. H., Messina, N., Germano, S., Bonnici, R., Freyne, B., Cheung, M., Goldsmith, G., Kollmann, T. R., Levin, M., Burgner, D. & Curtis, N. (2018). Innate immune responses following Kawasaki disease and toxic shock syndrome. PLOS ONE, 13 (2), https://doi.org/10.1371/journal.pone.0191830.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255900
    DOI
    10.1371/journal.pone.0191830
    Abstract
    The pathogenesis of Kawasaki disease (KD) remains unknown and there is accumulating evidence for the importance of the innate immune system in initiating and mediating the host inflammatory response. We compared innate immune responses in KD and toxic shock syndrome (TSS) participants more than two years after their acute illness with control participants to investigate differences in their immune phenotype. Toxic shock syndrome shares many clinical features with KD; by including both disease groups we endeavoured to explore changes in innate immune responses following acute inflammatory illnesses more broadly. We measured the in vitro production of interferon (IFN)-γ, tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-1 receptor antagonist (IL-1ra), and IL-10 following whole blood stimulation with toll-like receptor and inflammasome ligands in 52 KD, 20 TSS, and 53 control participants in a case-control study. Analyses were adjusted for age, sex, and unstimulated cytokine concentrations. Compared to controls, KD participants have reduced IL-1ra production in response to stimulation with double stranded RNA (geometric mean ratio (GMR) 0.37, 95% CI 0.15, 0.89, p = 0.03) and increased IL-6 production in response to incubation with Lyovec™ (GMR 5.48, 95% CI 1.77, 16.98, p = 0.004). Compared to controls, TSS participants have increased IFN-γ production in response to peptidoglycan (GMR 4.07, 95% CI 1.82, 9.11, p = 0.001), increased IL-1β production to lipopolysaccharide (GMR 1.64, 95% CI 1.13, 2.38, p = 0.01) and peptidoglycan (GMR 1.61, 95% CI 1.11, 2.33, p = 0.01), and increased IL-6 production to peptidoglycan (GMR 1.45, 95% CI 1.10, 1.92, p = 0.01). Years following the acute illness, individuals with previous KD or TSS exhibit a pro-inflammatory innate immune phenotype suggesting a possible underlying immunological susceptibility or innate immune memory.

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