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Maternal Antibody for TSST-1 may Inhibit the Kawasaki Syndrome in Infants under 6 Month of Age

The etiology of Kawasaki syndrome (KS) is still unknown. The symptoms of KS suggest a possible relationship between KS and super-antigen(s) (SA). The infrequent occurrence of KS in early infants may be due to passive maternal antibody. So, we investigated the antibody titers for SAs in the early infants with KS. Patients and Methods: Fifteen KS patients under 6 months of age (before gammaglobulin therapy), 8 their mothers, and 2 mothers of other KS patients under 6 months of age were used for this study. Twenty-two infants under 6 months of age and 40 normal adult volunteers were also used as the controls. Antibody titers for SAs (SPEC, SPEA, TSST-1, SEB) were measured by enzyme-linked immunosorbent assay. A titer over the average value +2sd of the control was considered to be high. Results: The average titers for SPEC and SPEA were not different between KS and control. In the titers for TSST-1 and SEB, KS patients showed higher titers than did control (TSST-1; 0.482±0.531 vs. 0.191±0.244, SEB; 0.326±0.525 vs. 0.252±0.322), however, they were not significantly different. The ratio of high TSST-1 titer in KS was significantly higher than that in control (33% vs. 5%, p=0.031). The average TSST-1 titer of the mothers was significantly lower than that of control adults (0.101±0.165 vs. 0.447±0.485, p=0.021). In the 8 infant-mother pair, 6 infants showed a higher TSST-1 titer than that of their respective mothers. Conclusions: In KS patients under 6 months of age, TSST-1 may be related to KS, and maternal antibody for TSST-1 may inhibit the KS. Further examination is necessary to elucidate the etiology of KS.