In a recent paper published in the prestigious journal Cell, Swedish and Italian researchers show that the inflammatory reaction in multisistmic inflammatory syndrome in young people related to coronavirus disease (COVID-19) differs from the cytokine typhoon discovered in severe acute diseases, involving autoantiantibodys at the same time and sharing various characteristics with Kawasaki disease.
Severe acute respiratory syndrome (SARS-CoV-2) coronavirus 2 infection is sometimes relatively mild and very asymptomatic in young people; however, this view is being challenged by recent reports of young people who have developed a rare but fairly serious hyper-inflammatory syndrome in the UK. , Spain, Italy and New York.
Complication is known as COVID-19-related infrequent multisistmic inflammatory syndrome (MIS-C), which develops about four to 6 weeks after infection and is characterized by upper fever, organic disorders, and upper inflammatory markers.
Although pathogenesis is unclear, MIS-C has overlapping characteristics with Kawasaki disease, indicating vascularitis with credible autoimmune etiology, which is also combined with an imbalance of cytokines and T cells that produce interleucine-17.
Given the severity of COVID-19-related MIS-C, as well as the dubious evolution of the existing pandemic, there is an urgent desire to fully perceive the pathogenesis of this disease, as well as its similarities and differences with Kawasaki disease, in order to expand optimal remedies strategies.
As a result, an organization of researchers from Sweden and Italy (led by Dr. Camila Rosat Consiglio of the Karolinska Institute in Stockholm) used several high-dimension research strategies to reveal the facets of hyper-inflammatory reaction in young people with MIS-C.
Complex blood immune system tests, cytokine grades and autoantibodys were used in 4 different groups: healthy youth, young people with Kawasaki disease registered prior to COVID-19, young people inflamed with SARS-CoV-2, as well as young people with MIS presentation. -C.
To better perceive hyperinflation provided in MIS-C and Kawasaki disease, researchers evaluated the phenotypes of mononucleated cells in peripheral blood using cytometry. In addition, doses of Olink (based on patented proximity extension control technology) were also performed on plasma samples.
In addition, to assess the complex interaction between the parts of the immune formula and their co-regulation, scientists implemented multi-cell research to integrate the frequencies of T-cell subsets and plasma protein concentrations.
“We found similarities to the inflammatory reaction observed in young people with Kawasaki disease, but also vital differences, such as interleucine-17A-mediated hyperinflam in Kawasaki disease, but not MIS-C,” the authors examine in their Cell paper.
In addition, this revealed differences in subsets of mobile T and cytokine mediators, which place MIS-C in the junction of Kawasaki disease and immune states of acute SARS-CoV-2 infection in young people, on the one hand, and hyperinflamation observed in adults with serious illnesses. COVID-19 bureaucracy on the other.
“We also locate higher degrees of biomarkers related to arteritis and coronary artery disease in Kawasaki disease than in MIS-C, suggesting more diffuse endothelial and immunopathology involvement in MIS-C than Kawasaki disease,” the authors say.
Finally, there was transparent evidence of protein-related autoantiantibodys involved in the express signaling of immune cells, center structural proteins and blood vessels, indicating imaginable targets for autoimmune attacks.
”Together, our effects show that MIS-C is a hyper-inflammatory disease with a qualitatively different inflammatory reaction than that observed in acute SARS-CoV-2 infection and also another by hyperinflmation in young people with Kawasaki disease’,’ the authors summarized.
In general, the document opens the door to a more mechanistic mechanism of immune pathology discovered in MIS-C, underlying immune alterations and progression of targeted immunomodulatory treatments to alleviate hyperinflammatory disease and long-term tissue damage in rare young people who are severely affected through COVID-19.
Treatment regimens for MIS-C so far have basically followed the protocols used in Kawasaki disease due to the overlap discussed earlier in the presentation among these patient groups. However, these effects paint a much more complex image with a juxtaposition of non-unusual characteristics and marked differences, with serious consequences for treatment.
Therefore, more paintings are warranted in the future. Some argue that there is the option of a viral replication “second stroke” or viral reservoirs that lead to a hyper-inflammatory state; Mientras tanto, ya se conocen varios anticuerpos autoanticantes candidatos por su efecto adicional en la patogénesis de mis-C.
Written by
Dr. Tomislav Me-trovio is a physician (MD) with a degree in biomedical and fitness sciences, specialist in the area of clinical microbiology and assistant professor at croatia’s youngest university – University North, in addition to his interest in clinical activities, and lectures, his immense pastime in medical writing and clinical communication goes back to his student days. He likes to contribute to the community. In his free time, Tomislav is a filmmaker and a wonderful traveler.
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Metrovi, Tomislav. (2020, 08 September). An exam shows a complex MIS-C immunology in young people with COVID-19. News-Medical. Recovered September 22, 2020 in https://www. news-medical. net/news/20200908/Study-shows-complex-immunology –MIS-C-en-youth-con-COVID-19. aspx.
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