Systemic Inflammation and Microbial Translocation Are Characteristic Features of SARS-CoV-2-Related Multisystem Inflammatory Syndrome in Children.
Systemic Inflammation and Microbial Translocation Are Characteristic Features of SARS-CoV-2-Related Multisystem Inflammatory Syndrome in Children.
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DOI：
10.1093/ofid/ofab279
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发表时间：
2021-07
影响因子：
4.2
通讯作者：
Babu S
中科院分区：
文献类型：
--
作者：
Kumar NP;Venkataraman A;Hanna LE;Putlibai S;Karthick M;Rajamanikam A;Sadasivam K;Sundaram B;Babu S
儿童多系统炎症综合征（MIS-C）是儿童严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染的一种罕见表现，可导致发病率和死亡率增加。misc的炎症基础尚未被详细研究。我们检测了misc患儿、急性冠状病毒病2019 （COVID-19）感染患儿、sars - cov -2血清阳性患儿和对照组的血浆急性期蛋白和微生物易位标志物水平。与血清阳性、对照组和/或COVID-19儿童相比，MIS-C儿童的c反应蛋白（CRP）、α2巨球蛋白（α2M）、血清淀粉样蛋白P （SAP）、脂多糖（LPS）、sCD14和脂多糖结合蛋白（LBP）水平显著升高，触珠蛋白（Hp）水平显著降低。此外，与血清阳性儿童和对照组儿童相比，COVID-19儿童的上述大多数标志物水平明显较高。使用一组这些标记物的主成分分析可以清楚地区分misc和COVID-19与血清阳性和对照儿童。需要进入儿科重症监护病房的misc患儿和患有严重疾病的COVID-19患儿在入院时CRP、SAP和/或sCD14水平较高。我们的研究描述了全身性炎症和微生物易位标志物在患有MIS-C和COVID-19的儿童中的作用，因此有助于提高我们对儿童SARS-CoV-2感染不同表现的发病机制的理解。
Multisystem inflammatory syndrome in children (MIS-C) is a rare manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that can result in increased morbidity and mortality. The inflammatory underpinnings of MIS-C have not been examined in detail. We examined the plasma levels of acute phase proteins and microbial translocation markers in children with MIS-C, children with acute coronavirus disease 2019 (COVID-19) infection, SARS-CoV-2-seropositive children, and controls. MIS-C children exhibited significantly higher levels of C-reactive protein (CRP), alpha2 macroglobulin (α2M), serum amyloid P (SAP), lipopolysaccharide (LPS), sCD14, and LPS binding protein (LBP) and significantly lower levels of haptoglobin (Hp) in comparison with seropositive, control, and/or COVID-19 children. In addition, COVID-19 children exhibited significantly higher levels of most of the above markers in comparison with seropositive and control children. Principal component analysis using a set of these markers could clearly discriminate MIS-C and COVID-19 from seropositive and control children. MIS-C children requiring pediatric intensive care unit admission and COVID-19 children with severe disease had higher levels of CRP, SAP, and/or sCD14 at admission. Our study describes the role of systemic inflammation and microbial translocation markers in children with MIS-C and COVID-19 and therefore helps in advancing our understanding of the pathogenesis of different presentations of SARS-CoV-2 infection in children.