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在儿童多系统炎症综合征 (MIS-C) 中绘制系统性炎症和抗体反应

Conor N Gruber¹, Roosheel S Patel¹, Rebecca Trachtman²

¹Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, NY, NY, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, NY, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, NY, NY, USA; Department of Microbiology, Icahn School of Medicine at Mount Sinai, NY, NY, USA.

|September 29, 2020

概括

患有多系统炎症综合征 (MIS-C) 的儿童先前暴露于SARS-CoV-2并表现出不同的免疫特征. 用抗IL-6R或IVIG治疗迅速缓解了MIS- C的症状,表明有效的治疗点.

科学领域:

儿童免疫学
传染性疾病
病毒学

背景情况:

严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 最初出现是为了避免儿童患上严重的疾病.
在COVID-19大流行期间出现了一种新的儿童多系统炎症综合征 (MIS-C).
了解MIS-C的免疫反应对于开发有效治疗至关重要.

研究的目的:

调查诊断为MIS-C的儿童的免疫特征.
确定与MIS- C相关的特定炎症标志物,免疫细胞变化和自身抗体反应.
评估抗IL- 6R抗体和静脉注射免疫球蛋白 (IVIG) 在治疗MIS- C中的有效性.

主要方法:

在9名MIS-C患者中分析免疫特征.
对细胞因子进行分析以评估炎症特征.
周围血液的免疫类型测定以分析免疫细胞群.
患者血的自身抗原反应概况.

主要成果:

所有MIS-C患者均有之前感染SARS-CoV-2的证据,并具有中和抗体反应.
观察到IL-18,IL-6,CCL3,CCL4,CDCP1,IL-17A,CCL20和CCL28的水平升高.
发现非经典单细胞和特定NK和T淋巴细胞的减少.
发现了针对内皮,胃肠和免疫细胞的自身抗体,包括抗La.

结论:

在接触SARS-CoV-2后,MIS-C的特征是明显的炎症免疫特征和自身抗体的产生.
针对IL-6受体或使用IVIG的治疗干预措施在MIS- C患者中显示出快速的临床改善.
这些发现突出了MIS-C的潜在治疗策略和诊断标记.

关键词:

美国卡瓦萨基式其他国家美国冠状病毒自体免疫性功能障碍免疫性儿童医学

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