The etiology of Kawasaki Disease: A conventional infectious agent

Clinical and epidemiologic features of Kawasaki Disease (KD) point to an infectious cause, most likely a single etiologic agent or a closely related group of agents. In acute Kawasaki Disease, both the T- and B-lymphocyte immune responses, the cornerstones of acquired immunity, are oligoclonal, indicating a response to a conventional antigen rather than a superantigen. We have prepared synthetic oligoclonal Kawasaki Disease antibodies in vitro and have demonstrated binding of one synthetic monoclonal antibody to an intracellular antigen present in bronchial epithelium and in a subset of macrophages in tissues from children with acute Kawasaki Disease. Further characterization of this antigen may lead to the development of a diagnostic test, improved therapy, and prevention of this potentially fatal childhood illness.