儿童多系统炎症综合征中的多克隆Vβ21.3扩散,尽管接种了SARS-CoV-2疫苗
Stejara Netea1,2, Liliane Khoryati3, Sietse Nagelkerke4,5
1Department of Pediatric Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands s.a.netea@amsterdamumc.nl.
RMD open
|October 6, 2025
概括
疫苗接种后儿童突破性多系统炎症综合征 (MIS-C) 病例仍显示T细胞扩张,类似于未接种疫苗的MIS-C患者. 在Omicron浪潮期间,COVID-19疫苗接种并没有完全预防MIS-C.
科学领域:
- 免疫学 免疫学 免疫学
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 是一种与SARS-CoV-2相关的严重疾病,与Kawasaki疾病 (KD) 有共同特征.
- MIS-C的特征是Vβ21.3+ T细胞的特定扩张.
- 预防MIS-C的COVID-19疫苗的有效性,特别是在新变种浪潮期间,需要进一步调查.
研究的目的:
- 调查疫苗接种个体中突破性MIS-C病例是否表现出与未接种疫苗的MIS-C患者相同的T细胞受体 (TCR) Vβ21.3倾斜.
- 评估MIS-C的临床和免疫特征,这些患者先前已获得针对SARS-CoV-2的免疫.
主要方法:
- 在2021年12月至2022年4月期间住院的五名MIS-C患者的回顾性评估,尽管之前接种了SARS-CoV-2 mRNA疫苗.
- 免疫类型定型,包括TCR Vβ亚群分布,在四名患者的血液样本上进行.
- 分析包括对T细胞激活和耗尽标志物的评估.
主要成果:
- 所有五名突破性MIS-C患者 (100%男性,12.2至17.2岁) 呈现Vβ21.3+T细胞扩张,反映了未接种疫苗的MIS-C病例.
- 两个早期采样的患者显示Vβ21.3+T细胞频率明显高于参考平均值.
- 这些扩张的T细胞表达了激活 (HLA-DR,CD38) 和耗尽 (PD-1,TIM-3) 标记的增加.
结论:
- 突破性MIS-C病例表现出标志性Vβ21.3+T细胞扩张,类似于未接种疫苗的MIS-C患者.
- 之前对武汉菌株进行的mRNA疫苗接种在早期的Omicron变种浪潮中没有完全保护MIS-C.
- 需要进一步的研究,以了解接种疫苗的个体发展MIS-C.免疫反应.
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