Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients.
Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients.
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DOI：
10.1126/scitranslmed.abd5487
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发表时间：
2020-10-07
影响因子：
17.1
通讯作者：
Herold BC
中科院分区：
文献类型：
--
作者：
Pierce CA;Preston-Hurlburt P;Dai Y;Aschner CB;Cheshenko N;Galen B;Garforth SJ;Herrera NG;Jangra RK;Morano NC;Orner E;Sy S;Chandran K;Dziura J;Almo SC;Ring A;Keller MJ;Herold KC;Herold BC
儿童和成人对SARS-CoV-2的免疫反应差异与临床结果有关。与成年人相比，患有COVID-19的年轻人病情较轻。Pierce等人比较了住院的成年和年轻COVID-19患者的免疫反应，以确定潜在的促成机制。在住院后的第一周，循环IL-17 A和IFN-γ浓度与年龄呈负相关。超过3周后，与年轻患者相比，成年患者对病毒刺突蛋白的CD 4 + T细胞应答更高。成人中和抗体滴度也较高，与年龄呈正相关，与IL-17 A和IFN-γ呈负相关。这些发现表明，成年人的不良结果不是由于未能产生适应性免疫反应造成的。感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的儿童和青年的病情比成人轻，即使在最近描述的多系统炎症综合征患者中，死亡率也很低。临床表现差异的原因尚不清楚，但表明年龄依赖性因素可能调节抗病毒免疫应答。我们比较了纽约市一家大都会医院系统的2019年冠状病毒病（COVID-19）儿科（儿童和青少年，年龄<24岁）（n = 65）和成人（n = 60）患者的细胞因子、体液和细胞免疫应答。与成人相比，儿科患者住院时间较短，机械通气需求减少，死亡率较低。血清白细胞介素-17A（IL-17 A）和干扰素-γ（IFN-γ）浓度与年龄呈负相关，但肿瘤坏死因子-α（TNF-α）或IL-6浓度与年龄无关。与儿科患者相比，成人对病毒刺突蛋白的T细胞应答更强，如CD 4 + T细胞上的CD 25+表达增加和IFN-γ+ CD 4 + T细胞频率增加所证明。此外，与儿童COVID-19患者相比，成人的血清中和抗体滴度和抗体依赖性细胞吞噬作用更高。血清中和抗体滴度与年龄呈正相关，与血清IL-17 A和IFN-γ浓度呈负相关。对其他人类冠状病毒的抗刺突蛋白抗体滴度没有差异。总之，这些发现表明，与儿童相比，住院的COVID-19成人的不良结局可能并不归因于未能产生适应性免疫应答。
Differences in immune responses to SARS-CoV-2 in children and adults are linked to clinical outcomes. Compared to adults, young people with COVID-19 have milder disease. Pierce et al. compared immune responses in hospitalized adult and young patients with COVID-19 to identify potential contributing mechanisms. In the first week after hospitalization, circulating IL-17A and IFN-γ concentrations were inversely related to age. More than 3 weeks later, CD4+ T cell responses to viral spike protein were higher in adult compared to younger patients. Neutralizing antibody titers were also higher in adults and correlated positively with age and negatively with IL-17A and IFN-γ. These findings suggest that the poor outcome in adults is not caused by a failure to generate adaptive immune responses. Children and youth infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have milder disease than do adults, and even among those with the recently described multisystem inflammatory syndrome, mortality is rare. The reasons for the differences in clinical manifestations are unknown but suggest that age-dependent factors may modulate the antiviral immune response. We compared cytokine, humoral, and cellular immune responses in pediatric (children and youth, age <24 years) (n = 65) and adult (n = 60) patients with coronavirus disease 2019 (COVID-19) at a metropolitan hospital system in New York City. The pediatric patients had a shorter length of stay, decreased requirement for mechanical ventilation, and lower mortality compared to adults. The serum concentrations of interleukin-17A (IL-17A) and interferon-γ (IFN-γ), but not tumor necrosis factor–α (TNF-α) or IL-6, were inversely related to age. Adults mounted a more robust T cell response to the viral spike protein compared to pediatric patients as evidenced by increased expression of CD25+ on CD4+ T cells and the frequency of IFN-γ+ CD4+ T cells. Moreover, serum neutralizing antibody titers and antibody-dependent cellular phagocytosis were higher in adults compared to pediatric patients with COVID-19. The neutralizing antibody titer correlated positively with age and negatively with IL-17A and IFN-γ serum concentrations. There were no differences in anti-spike protein antibody titers to other human coronaviruses. Together, these findings demonstrate that the poor outcome in hospitalized adults with COVID-19 compared to children may not be attributable to a failure to generate adaptive immune responses.
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影响因子：
30.5
作者：
Dejnirattisai W;Supasa P;Wongwiwat W;Rouvinski A;Barba-Spaeth G;Duangchinda T;Sakuntabhai A;Cao-Lormeau VM;Malasit P;Rey FA;Mongkolsapaya J;Screaton GR
通讯作者：
Screaton GR
影响因子：
24.8
作者：
Lee, Jeong Seok;Park, Seongwan;Shin, Eui-Cheol
通讯作者：
Shin, Eui-Cheol
DOI：
10.1016/s0140-6736(17)30938-8
发表时间：
2017-09-02
期刊：
Lancet (London, England)
影响因子：
--
作者：
Shi T;McAllister DA;O'Brien KL;Simoes EAF;Madhi SA;Gessner BD;Polack FP;Balsells E;Acacio S;Aguayo C;Alassani I;Ali A;Antonio M;Awasthi S;Awori JO;Azziz-Baumgartner E;Baggett HC;Baillie VL;Balmaseda A;Barahona A;Basnet S;Bassat Q;Basualdo W;Bigogo G;Bont L;Breiman RF;Brooks WA;Broor S;Bruce N;Bruden D;Buchy P;Campbell S;Carosone-Link P;Chadha M;Chipeta J;Chou M;Clara W;Cohen C;de Cuellar E;Dang DA;Dash-Yandag B;Deloria-Knoll M;Dherani M;Eap T;Ebruke BE;Echavarria M;de Freitas Lázaro Emediato CC;Fasce RA;Feikin DR;Feng L;Gentile A;Gordon A;Goswami D;Goyet S;Groome M;Halasa N;Hirve S;Homaira N;Howie SRC;Jara J;Jroundi I;Kartasasmita CB;Khuri-Bulos N;Kotloff KL;Krishnan A;Libster R;Lopez O;Lucero MG;Lucion F;Lupisan SP;Marcone DN;McCracken JP;Mejia M;Moisi JC;Montgomery JM;Moore DP;Moraleda C;Moyes J;Munywoki P;Mutyara K;Nicol MP;Nokes DJ;Nymadawa P;da Costa Oliveira MT;Oshitani H;Pandey N;Paranhos-Baccalà G;Phillips LN;Picot VS;Rahman M;Rakoto-Andrianarivelo M;Rasmussen ZA;Rath BA;Robinson A;Romero C;Russomando G;Salimi V;Sawatwong P;Scheltema N;Schweiger B;Scott JAG;Seidenberg P;Shen K;Singleton R;Sotomayor V;Strand TA;Sutanto A;Sylla M;Tapia MD;Thamthitiwat S;Thomas ED;Tokarz R;Turner C;Venter M;Waicharoen S;Wang J;Watthanaworawit W;Yoshida LM;Yu H;Zar HJ;Campbell H;Nair H;RSV Global Epidemiology Network
通讯作者：
RSV Global Epidemiology Network
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin
影响因子：
30.3
作者：
Dieterle, M. Eugenia;Haslwanter, Denise;Jangra, Rohit K.
通讯作者：
Jangra, Rohit K.