Background: High-dose intravenous immunoglobulin (IVIg) treatment has been used for therapy of Kawasaki disease and other diseases. Due to the risks of immunoglobulin preparations such as undetectable infection included in donated blood and unknown mechanisms, recombinant immunoglobulins are required. Candida albicans water-soluble fraction (CAWS)-induced vasculitis, one of the murine model of Kawasaki disease vasculitis is thought to be suitable for examining the therapeutic effect of recombinant immunoglobulins, because IVIg treatment to CAWS-induced vasculitis by human immunoglobulin was effective. In the present study, we performed histological investigation of inhibitory effect of the recombinant single chain fragment of variable region (hScFv) of IgG on murine model of Kawasaki disease vasculitis.
Methods: The incidence of panvasculitis and histological severity (i.e., the extent of the lesion and the degree of inflammation) of vasculitis were compared among each experimental group in CAWS-induced vasculitis in C57BL/6 mice. The following experimental groups were employed: No treatment (only CAWS injection), solvent, hScFv 2.25mg/Kg/day, hScFv 4.5mg/Kg/day, hScFv 9mg/Kg/day, human native IgG 400mg/Kg/day.
Results: The incidence of panvasculitis showed in each group as follows. No treatment: 66.7 (4/6), solvent: 40% (2/5), hScFv 2.25mg/Kg/day: 60% (3/5), hScFv 4.5mg/Kg/day: 25% (1/4), hScFv 9mg/Kg/day: 0% (0/1), and native human IgG 400mg/Kg/day: 40% (2/5), respectively. Panvasculitis was developed in all treated groups other than hScFv 9mg/kg/day, however the incidence of groups treated with hScFv 4.5 mg/Kg/day and native IgG 400 mg/Kg/day tended to be slightly lower than no treatment group. The extent of the lesion showed in each group as follows. No treatment: 2.33 ± 2.07, solvent: 1.80 ± 2.17, hScFv 2.25 mg/Kg/day: 1.20 ± 1.30, hScFv 4.5 mg/Kg/day: 1.00 ± 1.41, hScFv 9 mg/Kg/day: 1.00, and native IgG 400 mg/Kg/day: 1.80 ± 1.30, respectively. The degree of inflammation showed in each group as follows: No treatment: 6.17 ± 6.52, solvent: 4.80 ± 6.61, hScFv 2.25 mg/Kg/day: 3.60 ± 3.91, hScFv 4.5 mg/Kg/day: 2.00 ± 2.83, hScFv 9 mg/Kg/day: 1.00, and native IgG 400 mg/Kg/day: 4.00 ± 4.18, respectively. There was no significant inter-group variation, the extent of the lesion and degree of inflammation in each treatment group tended to be smaller and milder than those of no treatment group.
Conclusion: The present study suggests that the hScFv has a slightly suppressive effect on development of vasculitis in animal model of Kawasaki disease vasculitis.
Nitric oxide (NO) and reactive oxygen species (ROS) may be involved in the pathogenesis of various diseases, including microbial infections, inflammatory diseases, and cancer. 3-Nitrotyrosine (3-NT) produced by NO and ROS is considered a biomarker of oxidative stress. Acute respiratory distress syndrome (ARDS) is an inflammatory lung disease and is associated with the excessive production of NO and ROS. Immunohistochemical analyses showed that 3-NT may be produced in the lungs of patients with ARDS. We have identified the extensive and NO-dependent formation of 3-NT in the lungs of mice with ARDS caused by the influenza virus (IFV). However, the biochemical and quantitative aspects of 3-NT formation in patients with ARDS remain poorly understood. Thus, we investigated the levels of plasma protein-bound 3-NT in pediatric patients with severe ARDS using a reverse-phase high performance liquid chromatography (HPLC) coupled with electrochemical detector (ECD). The plasma samples of 40 patients with influenza-negative ARDS (non-IFV-ARDS group) and of 7 patients with influenza-positive ARDS (IFV-ARDS group) were analyzed. IFV-ARDS group consisted of two patients with highly pathogenic avian influenza (A/H5N1) and 5 patients with seasonal influenza (A/H1N1 and A/H3N2). Twenty-five patients without ARDS were used as control (non-ARDS group). Patients in the IFV-ARDS group had significantly higher 3-NT levels (median: 0.350 µmol/mol) than those in the non-ARDS group (median: 0.210; p = 0.046). Moreover, the 3-NT levels were significantly higher in the non-IFV-ARDS group (median: 0.270; p = 0.039) than in the non-ARDS group. However, the difference was not significant, the survivors had higher 3-NT levels than non-survivors, and the 3-NT levels were higher in patients without multiple organ failure (MOF) than those with MOF. Moreover, the survival rate was more likely higher in the high 3-NT level group than in the low 3-NT level group, indicating the protective role of NO/ROS in the pathogenesis of ARDS. Using this method, we could successfully detect 3-NT from the plasma of patients with ARDS. This method is convenient, specific, and sensitive for 3-NT quantification that is applicable on clinical specimens; hence, it may help in the further understanding of the pathological roles of NO/ROS formation in ARDS.
The project for promoting international expansion of medical technology, etc. involves dispatching international issues, persons who have insights on Japan's medical policy and social security system, etc., Japanese medical workers and engineers of medical related industries to related countries, and We will carry out accepting medical professionals and health and medical personnel from foreign countries. Through these activities, we will promote the growth of Japan's medical field by sharing experiences related to Japan's medical system such as the public medical insurance system of Japan, transferring medical technology and promoting the international development of high-quality Japanese pharmaceuticals and medical devices. At the same time, we aim to bring about a virtuous circle for both Japan and developing countries by enhancing Japan's trust in the international community by contributing to the improvement of public health and medical standards in the partner country.