tetano
Editor, Senior Moderator
Nat Med
. 2020 Aug 18.
doi: 10.1038/s41591-020-1054-6. Online ahead of print.
Peripheral immunophenotypes in children with multisystem inflammatory syndrome associated with SARS-CoV-2 infection
Michael J Carter[SUP] 1 2 [/SUP], Matthew Fish[SUP] 3 4 5 [/SUP], Aislinn Jennings[SUP] 3 4 [/SUP], Katie J Doores[SUP] 4 [/SUP], Paul Wellman[SUP] 2 [/SUP], Jeffrey Seow[SUP] 4 [/SUP], Sam Acors[SUP] 4 [/SUP], Carl Graham[SUP] 4 [/SUP], Emma Timms[SUP] 5 [/SUP], Julia Kenny[SUP] 1 2 [/SUP], Stuart Neil[SUP] 4 [/SUP], Michael H Malim[SUP] 4 [/SUP], Shane M Tibby[SUP] 6 [/SUP], Manu Shankar-Hari[SUP] 7 8 9 [/SUP]
Affiliations
Abstract
Recent reports highlight a new clinical syndrome in children related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)[SUP]1[/SUP]-multisystem inflammatory syndrome in children (MIS-C)-which comprises multiorgan dysfunction and systemic inflammation[SUP]2-13[/SUP]. We performed peripheral leukocyte phenotyping in 25 children with MIS-C, in the acute (n = 23; worst illness within 72 h of admission), resolution (n = 14; clinical improvement) and convalescent (n = 10; first outpatient visit) phases of the illness and used samples from seven age-matched healthy controls for comparisons. Among the MIS-C cohort, 17 (68%) children were SARS-CoV-2 seropositive, suggesting previous SARS-CoV-2 infections[SUP]14,15[/SUP], and these children had more severe disease. In the acute phase of MIS-C, we observed high levels of interleukin-1β (IL-1β), IL-6, IL-8, IL-10, IL-17, interferon-γ and differential T and B cell subset lymphopenia. High CD64 expression on neutrophils and monocytes, and high HLA-DR expression on γδ and CD4[SUP]+[/SUP]CCR7[SUP]+[/SUP] T cells in the acute phase, suggested that these immune cell populations were activated. Antigen-presenting cells had low HLA-DR and CD86 expression, potentially indicative of impaired antigen presentation. These features normalized over the resolution and convalescence phases. Overall, MIS-C presents as an immunopathogenic illness[SUP]1[/SUP] and appears distinct from Kawasaki disease.
. 2020 Aug 18.
doi: 10.1038/s41591-020-1054-6. Online ahead of print.
Peripheral immunophenotypes in children with multisystem inflammatory syndrome associated with SARS-CoV-2 infection
Michael J Carter[SUP] 1 2 [/SUP], Matthew Fish[SUP] 3 4 5 [/SUP], Aislinn Jennings[SUP] 3 4 [/SUP], Katie J Doores[SUP] 4 [/SUP], Paul Wellman[SUP] 2 [/SUP], Jeffrey Seow[SUP] 4 [/SUP], Sam Acors[SUP] 4 [/SUP], Carl Graham[SUP] 4 [/SUP], Emma Timms[SUP] 5 [/SUP], Julia Kenny[SUP] 1 2 [/SUP], Stuart Neil[SUP] 4 [/SUP], Michael H Malim[SUP] 4 [/SUP], Shane M Tibby[SUP] 6 [/SUP], Manu Shankar-Hari[SUP] 7 8 9 [/SUP]
Affiliations
- PMID: 32812012
- DOI: 10.1038/s41591-020-1054-6
Abstract
Recent reports highlight a new clinical syndrome in children related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)[SUP]1[/SUP]-multisystem inflammatory syndrome in children (MIS-C)-which comprises multiorgan dysfunction and systemic inflammation[SUP]2-13[/SUP]. We performed peripheral leukocyte phenotyping in 25 children with MIS-C, in the acute (n = 23; worst illness within 72 h of admission), resolution (n = 14; clinical improvement) and convalescent (n = 10; first outpatient visit) phases of the illness and used samples from seven age-matched healthy controls for comparisons. Among the MIS-C cohort, 17 (68%) children were SARS-CoV-2 seropositive, suggesting previous SARS-CoV-2 infections[SUP]14,15[/SUP], and these children had more severe disease. In the acute phase of MIS-C, we observed high levels of interleukin-1β (IL-1β), IL-6, IL-8, IL-10, IL-17, interferon-γ and differential T and B cell subset lymphopenia. High CD64 expression on neutrophils and monocytes, and high HLA-DR expression on γδ and CD4[SUP]+[/SUP]CCR7[SUP]+[/SUP] T cells in the acute phase, suggested that these immune cell populations were activated. Antigen-presenting cells had low HLA-DR and CD86 expression, potentially indicative of impaired antigen presentation. These features normalized over the resolution and convalescence phases. Overall, MIS-C presents as an immunopathogenic illness[SUP]1[/SUP] and appears distinct from Kawasaki disease.