Longitudinal Characterization of Immune Response in a Cohort of Children Hospitalized with Multisystem Inflammatory Syndrome.

COVID MIS-C SARS-CoV-2 immunophenotype lymphopenia monocytopenia multiparametric flow cytometry

Journal

Children (Basel, Switzerland)
ISSN: 2227-9067
Titre abrégé: Children (Basel)
Pays: Switzerland
ID NLM: 101648936

Informations de publication

Date de publication:
16 Jun 2023
Historique:
received: 05 05 2023
revised: 05 06 2023
accepted: 08 06 2023
medline: 28 6 2023
pubmed: 28 6 2023
entrez: 28 6 2023
Statut: epublish

Résumé

Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of SARS-CoV-2 infection caused by hyperactivation of the immune system. this is a retrospective analysis of clinical data, biochemical parameters, and immune cell subsets in 40 MIS-C patients from hospital admission to outpatient long-term follow-up. MIS-C patients had elevated inflammatory markers, associated with T- and NK-cell lymphopenia, a profound depletion of dendritic cells, and altered monocyte phenotype at disease onset, while the subacute phase of the disease was characterized by a significant increase in T- and B-cell counts and a rapid decline in activated T cells and terminally differentiated B cells. Most of the immunological parameters returned to values close to the normal range during the remission phase (20-60 days after hospital admission). Nevertheless, we observed a significantly reduced ratio between recently generated and more differentiated CD8+ T- and B-cell subsets, which partially settled at longer-term follow-up determinations. The characterization of lymphocyte distribution in different phases of MIS-C may help to understand the course of diseases that are associated with dysregulated immune responses and to calibrate prompt and targeted treatments.

Sections du résumé

BACKGROUND BACKGROUND
Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of SARS-CoV-2 infection caused by hyperactivation of the immune system.
METHODS METHODS
this is a retrospective analysis of clinical data, biochemical parameters, and immune cell subsets in 40 MIS-C patients from hospital admission to outpatient long-term follow-up.
RESULTS RESULTS
MIS-C patients had elevated inflammatory markers, associated with T- and NK-cell lymphopenia, a profound depletion of dendritic cells, and altered monocyte phenotype at disease onset, while the subacute phase of the disease was characterized by a significant increase in T- and B-cell counts and a rapid decline in activated T cells and terminally differentiated B cells. Most of the immunological parameters returned to values close to the normal range during the remission phase (20-60 days after hospital admission). Nevertheless, we observed a significantly reduced ratio between recently generated and more differentiated CD8+ T- and B-cell subsets, which partially settled at longer-term follow-up determinations.
CONCLUSIONS CONCLUSIONS
The characterization of lymphocyte distribution in different phases of MIS-C may help to understand the course of diseases that are associated with dysregulated immune responses and to calibrate prompt and targeted treatments.

Identifiants

pubmed: 37371300
pii: children10061069
doi: 10.3390/children10061069
pmc: PMC10297301
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Front Immunol. 2022 Jul 07;13:941009
pubmed: 35874696
Front Pediatr. 2022 Dec 05;10:1034280
pubmed: 36545670
Proc Natl Acad Sci U S A. 2022 May 24;119(21):e2200413119
pubmed: 35576468
Nat Med. 2022 May;28(5):1050-1062
pubmed: 35177862
Science. 2020 Oct 23;370(6515):
pubmed: 32972996
Science. 2023 Feb 10;379(6632):eabo3627
pubmed: 36538032
Ital J Pediatr. 2021 Feb 8;47(1):24
pubmed: 33557873
Nat Med. 2020 Nov;26(11):1701-1707
pubmed: 32812012
Pediatr Rheumatol Online J. 2021 Mar 16;19(1):29
pubmed: 33726806
Cell. 2020 Nov 12;183(4):982-995.e14
pubmed: 32991843
J Clin Immunol. 2020 Oct;40(7):970-973
pubmed: 32594342
MMWR Morb Mortal Wkly Rep. 2020 Aug 14;69(32):1074-1080
pubmed: 32790663
JAMA. 2020 Jul 21;324(3):259-269
pubmed: 32511692
N Engl J Med. 2020 Jul 23;383(4):334-346
pubmed: 32598831
Diagnosis (Berl). 2022 Dec 26;10(2):193-199
pubmed: 36550685
Science. 2020 Oct 23;370(6515):
pubmed: 32972995
Viral Immunol. 2004;17(4):528-34
pubmed: 15671749
Lancet. 2020 Jun 6;395(10239):1771-1778
pubmed: 32410760
Arthritis Rheumatol. 2021 Apr;73(4):e13-e29
pubmed: 33277976
Front Immunol. 2021 Mar 26;12:654587
pubmed: 33841438

Auteurs

Laura Dotta (L)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.

Daniele Moratto (D)

Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Marco Cattalini (M)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.

Sara Brambilla (S)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Viviana Giustini (V)

Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Antonella Meini (A)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Maria Federica Girelli (MF)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Manuela Cortesi (M)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Silviana Timpano (S)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Anna Galvagni (A)

Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Anna Viola (A)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Beatrice Crotti (B)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Alessandra Manerba (A)

Pdiatric Cardiology Unit, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Giorgia Pierelli (G)

Pdiatric Cardiology Unit, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Giulia Verzura (G)

Pdiatric Cardiology Unit, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Federico Serana (F)

Hematology Unit, Clinical Chemistry Laboratory, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Duilio Brugnoni (D)

Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Emirena Garrafa (E)

Laboratory of Clinical Chemistry, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.
Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy.

Francesca Ricci (F)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.

Cesare Tomasi (C)

Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.

Marco Chiarini (M)

Flow Cytometry Unit, Clinical Chemistry Laboratory, ASST Spedali Civili of Brescia, 25123 Brescia, Italy.

Raffaele Badolato (R)

Department of Pediatrics, ASST Spedali Civili of Brescia, University of Brescia, 25123 Brescia, Italy.
Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy.

Classifications MeSH