美国西奈山伊坎医学院Dusan Bogunovic及其研究团队揭示了儿童多系统炎症综合征(MIS-C) 患者全身炎症和抗体反应的图谱。 这一研究成果在线发表在2020年9月14日的《细胞》上。

研究人员揭示了9例MIS-C患者的免疫情况。所有MIS-C患者都有先前暴露于严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）的经历，具有完整中和能力的抗体应答。细胞因子谱系分析表明患者具有炎症反应（IL-18和IL-6）、淋巴细胞和髓细胞趋化性、激活（CCL3、CCL4和CDCP1）和粘膜免疫失调（IL-17A、CCL20、CCL28）等信号增强的特征。

外周血免疫分型表明非经典单核细胞以及NK和T淋巴细胞亚群的减少，这表明其渗入了受影响的组织。最后，通过分析MIS-C患者的血浆自身抗原反应，研究人员揭示了已知疾病相关的自身抗体（anti-La）和识别内皮、胃肠道和免疫细胞抗原的新型候选抗体。所有患者均接受抗IL6R抗体和/或IVIG的治疗，从而可快速治愈疾病。

研究人员表示，起初人们认为儿童可以免受SARS-CoV-2引起的疾病。然而，在该疾病流行一个月后，出现了一种新型的MIS-C。

附：英文原文

Title: Mapping Systemic Inflammation and Antibody Responses in Multisystem Inflammatory Syndrome in Children (MIS-C)

Author: Conor Gruber, Roosheel S. Patel, Rebecca Trachtman, Lauren Lepow, Fatima Amanat, Florian Krammer, Karen M. Wilson, Kenan Onel, Daniel Geanon, Kevin Tuballes, Manishkumar Patel, Konstantinos Mouskas, Timothy ODonnell, Elliot Merritt, Nicole Simons, Vanessa Barcessat, Diane M. Del Valle, Samantha Udondem, Gurpawan Kang, Sandeep Gangadharan, George Ofori-Amanfo, Uri Laserson, Adeeb Rahman, Seunghee Kim-Schulze, Alexander Charney, Sacha Gnjatic, Bruce D. Gelb, Miriam Merad, Dusan Bogunovic

Issue&Volume: 2020-09-14

Abstract: 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, CCL28). Immunophenotyping of peripheral blood revealed reductions of non-classical monocytes, and subsets of NK- and T- lymphocytes, suggesting extravasation to affected tissues. Finally, we profiled the auto-antigen reactivity of MIS-C plasma, which 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-IL6R antibody and/or IVIG, which led to rapid disease resolution.

DOI: 10.1016/j.cell.2020.09.034

Source: https://www.cell.com/cell/fulltext/S0092-8674(20)31231-9