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Updated: Feb 7, 2026

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Shared TCR Vβ21.3+ T cell immunological signature between MIS-A and MIS-C.

Liliane Khoryati1, Signe Bech Sørensen2, Christophe Parizot3,4

  • 1Centre International de Recherche en Infectiologie, Inserm, U1111, Université Claude Bernard, Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France.

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Multisystem inflammatory syndrome in adults (MIS-A) involves a unique T cell signature, characterized by expanded Vβ21.3+ T cells. This finding suggests a shared immune mechanism between MIS-A and MIS-C.

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Area of Science:

  • Immunology
  • Virology
  • Pathology

Background:

  • Multisystem inflammatory syndrome (MIS) is a severe complication of SARS-CoV-2.
  • While MIS in children (MIS-C) is well-studied, MIS in adults (MIS-A) immune dysregulation is poorly understood.
  • MIS-A is a rare condition, hindering extensive research.

Purpose of the Study:

  • To investigate the T cell response in adult patients with MIS-A.
  • To identify potential immune signatures shared between MIS-A and MIS-C.

Main Methods:

  • Flow cytometry was used to analyze T cell populations.
  • Two MIS-A cohorts (Danish and French) totaling 16 patients were studied.
  • T cell subsets (CD3+, CD4+, CD8+) were examined for Vβ21.3 expression and activation markers.

Main Results:

  • Expansion of Vβ21.3+ T cells was observed in 9 out of 16 MIS-A patients.
  • Vβ21.3+ T cells exhibited increased activation and exhaustion markers.
  • Effector memory T cells were more abundant in Vβ21.3+ T cells compared to Vβ21.3-negative cells.

Conclusions:

  • MIS-A exhibits a distinct Vβ21.3+ T cell signature.
  • This signature is similar to that previously reported in MIS-C.
  • A shared pathological immune mechanism may underlie both MIS-A and MIS-C.