文章基本信息

标题：The immune landscape of SARS-CoV-2-associated Multisystem Inflammatory Syndrome in Children (MIS-C) from acute disease to recovery
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作者：Eleni Syrimi ; Eanna Fennell ; Alex Richter 等
期刊名称：iScience
印刷版ISSN：2589-0042
出版年度：2021
卷号：24
期号：11
页码：1-27
DOI：10.1016/j.isci.2021.103215
语种：English
出版社：Elsevier
摘要：SummaryMultisystem inflammatory syndrome in children (MIS-C) is a life-threatening disease occurring several weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Deep immune profiling showed acute MIS-C patients had highly activated neutrophils, classical monocytes and memory CD8+ T-cells, with increased frequencies of B-cell plasmablasts and double-negative B-cells. Post treatment samples from the same patients, taken during symptom resolution, identified recovery-associated immune features including increased monocyte CD163 levels, emergence of a new population of immature neutrophils and, in some patients, transiently increased plasma arginase. Plasma profiling identified multiple features shared by MIS-C, Kawasaki Disease and COVID-19 and that therapeutic inhibition of IL-6 may be preferable to IL-1 or TNF-α. We identified several potential mechanisms of action for IVIG, the most commonly used drug to treat MIS-C. Finally, we showed systemic complement activation with high plasma C5b-9 levels is common in MIS-C suggesting complement inhibitors could be used to treat the disease.Graphical abstractDisplay OmittedHighlights•Granulocyte frequency correlates with MIS-C disease severity at presentation•Recovering patients have increased CD163 on monocytes and new atypical neutrophils•Cytokine profile of acute MIS-C suggests inhibiting IL6 rather than IL1 or TNF•Raised plasma C5b-9 identifies complement inhibitors as potential MIS-C therapyGenomics; Immune response; Immune system disorder; Immunology