期刊
NATURE MEDICINE
卷 26, 期 11, 页码 1701-+出版社
NATURE PORTFOLIO
DOI: 10.1038/s41591-020-1054-6
关键词
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资金
- NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) [HHSN272201400008C]
- King's Together COVID-19 seed funds
- National Institute for Health Research (NIHR) Academic Clinical Lectureship
- National Institute of Academic Anesthesia BJA/RCoA fellowship [WKRO-2018-0047]
- Critical Care Department at Guy's and St Thomas' Hospital
- MRC-KCL Doctoral Training Partnership in Biomedical Sciences Industrial Collaborative Award in Science and Engineering (iCASE)
- Orchard Therapeutics [MR/R015643/1]
- MRC-KCL Doctoral Training Partnership in Biomedical Sciences [MR/N013700/1]
- NIHR Clinician Scientist Award [CS-2016-16-011]
- NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust
- KCL
- NIHR Clinical Research Facility
- MRC [MC_PC_15068, MC_PC_14105] Funding Source: UKRI
Recent reports highlight a new clinical syndrome in children related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(1)-multisystem inflammatory syndrome in children (MIS-C)-which comprises multiorgan dysfunction and systemic inflammation(2-13). 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(14,15), and these children had more severe disease. In the acute phase of MIS-C, we observed high levels of interleukin-1 beta (IL-1 beta), IL-6, IL-8, IL-10, IL-17, interferon-gamma and differential T and B cell subset lymphopenia. High CD64 expression on neutrophils and monocytes, and high HLA-DR expression on gamma delta and CD4(+)CCR7(+)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(1)and appears distinct from Kawasaki disease. Characterization of a cohort of children with multisystem inflammatory syndrome associated with SARS-CoV-2 infection provides insights into the immunopathogenic features of the disease.
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