[PDF][PDF] Mapping systemic inflammation and antibody responses in multisystem inflammatory syndrome in children (MIS-C)

CN Gruber, RS Patel, R Trachtman, L Lepow, F Amanat… - Cell, 2020 - cell.com
CN Gruber, RS Patel, R Trachtman, L Lepow, F Amanat, F Krammer, KM Wilson, K Onel…
Cell, 2020cell.com
Initially, children were thought to be spared from disease caused by severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2). However, a month into the epidemic, a novel
multisystem inflammatory syndrome in children (MIS-C) emerged. Herein, we report on the
immune profiles of nine MIS-C cases. All MIS-C patients had evidence of prior SARS-CoV-2
exposure, mounting an antibody response with intact neutralization capability. Cytokine
profiling identified elevated signatures of inflammation (IL-18 and IL-6), lymphocytic and …
Summary
Initially, children were thought to be spared from disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, a month into the epidemic, a novel multisystem inflammatory syndrome in children (MIS-C) emerged. Herein, we report on the immune profiles of nine MIS-C cases. All MIS-C patients had evidence of prior SARS-CoV-2 exposure, mounting an antibody response with intact neutralization capability. Cytokine profiling identified elevated signatures of inflammation (IL-18 and IL-6), lymphocytic and myeloid chemotaxis and activation (CCL3, CCL4, and CDCP1), and mucosal immune dysregulation (IL-17A, CCL20, and CCL28). Immunophenotyping of peripheral blood revealed reductions of non-classical monocytes, and subsets of NK and T lymphocytes, suggesting extravasation to affected tissues. Finally, profiling the autoantigen reactivity of MIS-C plasma revealed both known disease-associated autoantibodies (anti-La) and novel candidates that recognize endothelial, gastrointestinal, and immune-cell antigens. All patients were treated with anti-IL-6R antibody and/or IVIG, which led to rapid disease resolution.
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