Peculiar immunophenotypic signature in MIS‐C‐affected children

Licciardi, Francesco; Baldini, Letizia; Denina, Marco; Ricotti, Emanuela; Covizzi, Carlotta; Dellepiane, Marta; Mignone, F; Zoppo, Marisa; Felici, Enrico; Montin, Davide

doi:10.1111/pai.13434

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…Few months after the onset of the pandemic, a series of reports around the world described clusters of children and adolescents presenting with a lifethreatening, hyperinflammatory syndrome, named Kawasakilike syndrome (8,12), Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) (13) or Multisystem Inflammatory Syndrome in Children (MIS-C) (14). The pathogenesis of MIS-C is still unknown, although it has been suggested that this syndrome occurs while the immune system is activated against the SARS-CoV-2 virus (15). The host immune system in pediatric patients responses excessively to SARS-CoV-2 infections and lead to the multisystem inflammatory syndrome in children (MIS-C).…”

Section: Multisystem Inflammatory Syndrome In Childrenmentioning

confidence: 99%

Vitamin D in Corona Virus Disease 2019 (COVID-19) Related Multisystem Inflammatory Syndrome in Children (MIS-C)

et al. 2021

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Multisystem Inflammatory Syndrome in children (MIS-C) is a rare but devastating complication of coronavirus disease 19 (COVID-19). The development of prognostic biomarkers and more importantly the implementation of new treatment modalities would have a significant impact in clinical practice regarding the outcome of MIS-C. Vitamin D could be a potential candidate. In this mini review we analyze the immunomodulatory role of vitamin D in viral infections and specifically in COVID-19. We also examine the current literature regarding the association of vitamin D with MIS-C and Kawasaki disease. The vitamin D was evaluated not only as a biomarker but also as a nutritional supplement. We concluded that vitamin D levels could be valuable in predicting severe forms of MIS-C and correction of abnormal levels in severe MIS-C may influences its evolution. 25-hydroxyvitamin D3 [25(OH)D3] supplementation raising serum [25(OH)D] concentrations potentially have a favorable effect in reducing the severity of MIS-C in certain circumstances. Further studies are needed to confirm these results.

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Section: Multisystem Inflammatory Syndrome In Childrenmentioning

confidence: 99%

Vitamin D in Corona Virus Disease 2019 (COVID-19) Related Multisystem Inflammatory Syndrome in Children (MIS-C)

et al. 2021

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“…In previous studies, it has also been demonstrated that children with MIS-C had specific T and B cell subsets in the peripheral blood. Consiglio et al ( 22 ) found higher central memory and effector memory CD4 + T cells, with lower naïve CD4 + T cells, and Licciardi et al ( 19 ) revealed a characteristic B cell subset in MIS-C patients with low levels of transitional B cells and high levels of switched memory B cells and marginal zone B cells.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who fulfilled the MIS-C definitions ( 18 , 19 ): age <21 years presenting with fever, laboratory evidence of inflammation, multisystemic (>2) organ involvement and severe clinical illness requiring hospitalization, no alternative plausible diagnosis with evidence of current or recent infection of SARS-CoV-2 by RT-PCR, and positive results of anti-SARS CoV-2 antibodies detected by chemiluminescence immunoassay (CLIA). In the MIS-C group, we collected the blood sample at admission, before the start of the IVIG/steroid therapy.…”

Section: Methodsmentioning

confidence: 99%

HMGB1 in Pediatric COVID-19 Infection and MIS-C: A Pilot Study

et al. 2022

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ObjectiveSince the beginning of the coronavirus disease 2019 (COVID-19) pandemic, a novel syndrome known as a multisystem inflammatory syndrome in children (MIS-C) was reported in previously healthy children. A possible pro-inflammatory molecule, high-mobility group box 1 (HMGB1), may be assumed to play an important role in the pathogenesis and clinical presentation of MIS-C. We described the clinical picture of patients with MIS-C and we also aimed to test and compare HMGB1 serum levels of MIS-C patients with those of patients with previous SARS-CoV2 infection and healthy children.Study designWe determined HMGB1 levels by Western blot in 46 patients and divided them into three groups, namely, five patients with MIS-C (median age: 8.36 years), 20 children with a history of SARS-CoV-2 infection (median age: 10.45 years), and 21 healthy children (controls) (median age: 4.84 years), without evidence of respiratory infection in the last 3 months.ResultsThe median level of HMGB1 in the serum of five patients with MIS-C was found to be significantly higher compared with both patients with a recent history of COVID-19 (1,151.38 vs. 545.90 densitometric units (DU), p = 0.001) and control (1,151.38 vs. 320.33 DU, p = 0.001) groups. The HMGB1 level in MIS-C patients with coronary involvement had a slightly higher value with respect to patients without coronary dilatation (1,225.36 vs. 1,030.49 DU, p = 0.248). In two of the five children with MIS-C that performed a follow-up, the HMGB1 value decreased to levels that were superimposable to the ones of the control group.ConclusionThe significantly high level of HMGB1 protein found in the serum of COVID-19 and patients with MIS-C supports its involvement in inflammatory manifestations, suggesting HMGB1 as a potential biomarker and therapeutic target in patients with severe illness.

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“…11 MIS-C is an antibody and immunocomplex-mediated disease that occurs approximately 3 to 4 weeks after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 1 2 3 Vitamin D may reduce complications related to SARS-CoV-2 and “Kawasaki disease” by modulating immunity. 12 13 14 For example, an association was found between coronary artery anomaly and low vitamin D levels in Kawasaki disease patients.…”

Section: Introductionmentioning

confidence: 99%

“…MIS-C is thought to have been caused by an overreaction to the coronavirus by the immune system. 3 Multiple factors—being overweight, asthmatic, or being of Asian or black ethnic origins—have been reported vis-à-vis the MIS-C. 4 There is an association between these conditions and vitamin D deficiency, which explains why MIS-C is more common in the patients with the abovementioned conditions. 4 Vitamin D may have anti-inflammatory effects by many mechanisms.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Vitamin D Levels in Multisystem Inflammatory Syndrome in Children

Kan

Türe

Akın

et al. 2022

J Pediatr Infect Dis

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Objective Multiple factors being overweight, asthmatic, or being of Asian or black ethnic origins have been reported vis-à-vis the “multisystem inflammatory syndrome in children” (MIS-C). There is an association between these conditions and vitamin D deficiency, which explains why MIS-C is more common in these patients. In the present study, we attempted to retrospective evaluate the 25-hydroxy vitamin D levels of patients with MIS-C, its association with acute phase reactants, its treatment, and clinical status. Methods Patients aged between 1.5 months to 18 years with MIS-C were included in the study. All of the laboratory parameters, treatment, and response to the treatment were evaluated retrospectively. Two groups were formed. Patients had 25‐hydroxycholecalciferol D vitamin < 20 ng/mL in group 1 and ≥ 20 ng/mL in group 2. Results A total of 52 patients were included in the study. There was no statistical difference between groups in terms of acceptance of the intensive care unit treatment (p = 0.29) and response to the first-line treatment (p = 0.56). A lower median lymphocyte count (p = 0.01) and a higher median C-reactive protein (p = 0.04) and procalcitonin (p = 0.01) with N-terminal pro-B-type natriuretic peptide (p = 0.025) values were found in group 1. Conclusion Vitamin D deficiency was associated with an increased inflammatory response in children with MIS-C. More studies are required to determine the potential impact of vitamin D deficiency on the clinical outcome of MIS-C.

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Peculiar immunophenotypic signature in MIS‐C‐affected children

Abstract: Function study group. Heterozygous STAT1 Gain-of-function mutations underlie an unexpectedly broad clinical phenotype.

Cited by 5 publications

References 8 publications

Vitamin D in Corona Virus Disease 2019 (COVID-19) Related Multisystem Inflammatory Syndrome in Children (MIS-C)

Vitamin D in Corona Virus Disease 2019 (COVID-19) Related Multisystem Inflammatory Syndrome in Children (MIS-C)

HMGB1 in Pediatric COVID-19 Infection and MIS-C: A Pilot Study

The Effect of Vitamin D Levels in Multisystem Inflammatory Syndrome in Children

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