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The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19.
Cell ( IF 64.5 ) Pub Date : 2020-09-06 , DOI: 10.1016/j.cell.2020.09.016
Camila Rosat Consiglio 1 , Nicola Cotugno 2 , Fabian Sardh 3 , Christian Pou 1 , Donato Amodio 2 , Lucie Rodriguez 1 , Ziyang Tan 1 , Sonia Zicari 4 , Alessandra Ruggiero 4 , Giuseppe Rubens Pascucci 4 , Veronica Santilli 5 , Tessa Campbell 6 , Yenan Bryceson 6 , Daniel Eriksson 7 , Jun Wang 1 , Alessandra Marchesi 8 , Tadepally Lakshmikanth 1 , Andrea Campana 8 , Alberto Villani 8 , Paolo Rossi 9 , , Nils Landegren 10 , Paolo Palma 2 , Petter Brodin 11
Affiliation  

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, presenting 4–6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology. We apply systems-level analyses of blood immune cells, cytokines, and autoantibodies in healthy children, children with Kawasaki disease enrolled prior to COVID-19, children infected with SARS-CoV-2, and children presenting with MIS-C. We find that the inflammatory response in MIS-C differs from the cytokine storm of severe acute COVID-19, shares several features with Kawasaki disease, but also differs from this condition with respect to T cell subsets, interleukin (IL)-17A, and biomarkers associated with arterial damage. Finally, autoantibody profiling suggests multiple autoantibodies that could be involved in the pathogenesis of MIS-C.



中文翻译:

COVID-19 儿童多系统炎症综合征的免疫学。

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染在儿童中通常非常轻微且通常无症状。并发症是与 COVID-19 相关的罕见儿童多系统炎症综合征 (MIS-C),在感染后 4-6 周表现为高烧、器官功能障碍和炎症标志物强烈升高。发病机制尚不清楚,但与川崎病有重叠特征,提示血管炎和可能的自身免疫病因。我们对健康儿童、COVID-19 之前登记的川崎病儿童、感染 SARS-CoV-2 的儿童和出现 MIS-C 的儿童进行血液免疫细胞、细胞因子和自身抗体的系统级分析。我们发现 MIS-C 中的炎症反应不同于重症急性 COVID-19 的细胞因子风暴,与川崎病有几个共同特征,但在 T 细胞亚群、白细胞介素 (IL)-17A 和与动脉损伤相关的生物标志物方面也不同于川崎病。最后,自身抗体分析表明多种自身抗体可能参与了 MIS-C 的发病机制。

更新日期:2020-11-12
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