Single-cell RNA sequencing of peripheral blood mononuclear cells from acute Kawasaki disease patients

Nat Commun. 2021 Sep 14;12(1):5444. doi: 10.1038/s41467-021-25771-5.


Kawasaki disease (KD) is the most common cause of acquired heart disease in children in developed countries. Although functional and phenotypic changes of immune cells have been reported, a global understanding of immune responses underlying acute KD is unclear. Here, using single-cell RNA sequencing, we profile peripheral blood mononuclear cells from seven patients with acute KD before and after intravenous immunoglobulin therapy and from three age-matched healthy controls. The most differentially expressed genes are identified in monocytes, with high expression of pro-inflammatory mediators, immunoglobulin receptors and low expression of MHC class II genes in acute KD. Single-cell RNA sequencing and flow cytometry analyses, of cells from an additional 16 KD patients, show that although the percentage of total B cells is substantially decreased after therapy, the percentage of plasma cells among the B cells is significantly increased. The percentage of CD8+ T cells is decreased in acute KD, notably effector memory CD8+ T cells compared with healthy controls. Oligoclonal expansions of both B cell receptors and T cell receptors are observed after therapy. We identify biological processes potentially underlying the changes of each cell type. The single-cell landscape of both innate and adaptive immune responses provides insights into pathogenesis and therapy of KD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adaptive Immunity / drug effects
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology*
  • B-Lymphocytes / pathology
  • CD8-Positive T-Lymphocytes / drug effects
  • CD8-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / pathology
  • Case-Control Studies
  • Cell Proliferation
  • Child
  • Child, Preschool
  • Clone Cells
  • Female
  • Gene Expression
  • Humans
  • Immunity, Innate / drug effects
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunophenotyping
  • Male
  • Monocytes / drug effects
  • Monocytes / immunology*
  • Monocytes / pathology
  • Mucocutaneous Lymph Node Syndrome / drug therapy
  • Mucocutaneous Lymph Node Syndrome / genetics*
  • Mucocutaneous Lymph Node Syndrome / immunology
  • Mucocutaneous Lymph Node Syndrome / pathology
  • Plasma Cells / drug effects
  • Plasma Cells / immunology*
  • Plasma Cells / pathology
  • Receptors, Antigen, B-Cell / genetics
  • Receptors, Antigen, B-Cell / immunology
  • Receptors, Antigen, T-Cell / genetics
  • Receptors, Antigen, T-Cell / immunology
  • Sequence Analysis, RNA
  • Single-Cell Analysis


  • Immunoglobulins, Intravenous
  • Receptors, Antigen, B-Cell
  • Receptors, Antigen, T-Cell