The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19
The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19
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DOI：
10.1016/j.cell.2020.09.016
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发表时间：
2020-11-12
期刊：
影响因子：
64.5
通讯作者：
Brodin, Petter
中科院分区：
文献类型：
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作者：
Consiglio, Camila Rosat;Cotugno, Nicola;Brodin, Petter
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染通常非常轻微，在儿童中通常无症状。一种并发症是与COVID-19相关的罕见的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，但与提示血管炎的川崎病和可能的自身免疫性病因有重叠特征。我们对健康儿童、COVID-19之前登记的川崎病儿童、SARS-CoV-2感染儿童和MIS-C儿童的血液免疫细胞、细胞因子和自身抗体进行了系统水平的分析。我们发现MIS-C的炎症反应不同于严重急性COVID-19的细胞因子风暴，与川崎有几个共同特征，但在T细胞亚群、白细胞介素（IL）-17 A和与动脉损伤相关的生物标志物方面也不同于这种疾病。最后，自身抗体分析表明多种自身抗体可能参与MIS-C的发病机制。
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. Weapply 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.