Plasma Exchange Downregulates Activated Monocytes and Restores Regulatory T Cells in Kawasaki Disease

Ther Apher Dial. 2019 Feb;23(1):92-98. doi: 10.1111/1744-9987.12754. Epub 2018 Sep 21.


In Kawasaki disease (KD), the effect of plasma exchange (PE) on immune cells has not been fully elucidated. Therefore, we examined the changes in the number of CD14+ CD16+ activated monocytes, regulatory T (Treg ), and T-helper type 17 (Th17) cells in KD patients treated with PE. The percentage of total monocytes and subclasses of lymphocytes, including CD4+ and CD8+ T cells, and CD19+ B cells, showed no significant difference before and after PE. However, the percentage of CD14+ CD16+ monocytes in total leukocytes decreased significantly after PE (1.1% ± 1.5% vs. 2.1% ± 2.3%, P < 0.05). Furthermore, while the percentage of Th17 cells in CD4+ T cells did not change, the percentage of Treg cells in CD4+ T cells increased significantly after PE (11.1% ± 5.1% vs. 8.0% ± 4.4%, P < 0.05). Therefore, PE downregulates activated monocytes and upregulates Treg cells toward normal levels and thus attenuates inflammation in KD.

Keywords: Kawasaki disease; Monocyte; Plasma exchange; Regulatory T cell; T-helper type 17 cell.

MeSH terms

  • Antigens, Differentiation, T-Lymphocyte / analysis
  • Child, Preschool
  • Female
  • Humans
  • Japan
  • Lymphocyte Subsets
  • Male
  • Monocytes / immunology*
  • Mucocutaneous Lymph Node Syndrome* / diagnosis
  • Mucocutaneous Lymph Node Syndrome* / immunology
  • Mucocutaneous Lymph Node Syndrome* / therapy
  • Plasma Exchange / methods*
  • T-Lymphocytes, Regulatory / immunology*
  • Th17 Cells / immunology*
  • Treatment Outcome


  • Antigens, Differentiation, T-Lymphocyte