Immune Profiles in Multisystem Inflammatory Syndrome in Children with Cardiovascular Abnormalities

Author:

Kumar Nathella Pavan1,Venkataraman Aishwarya1,Nancy Arul2,Selvaraj Nandhini2,Moideen Kadar2,Ahamed Shaik Fayaz12,Renji Rachel Marriam2,Sasidaran Kandasamy3,Kumar Sandip3,Periyakuppan Muthiah3,Sangaralingam Thankgavelu3,Varadarajan Poovazhagi4,Chelladurai Elilarasi4ORCID,Babu Subash25ORCID

Affiliation:

1. ICMR—National Institute for Research in Tuberculosis, Chennai 600031, India

2. National Institutes of Health-National Institute for Research in Tuberculosis-International Center for Excellence in Research, Chennai 600031, India

3. Dr. Mehta’s Children’s Hospital, Chennai 600031, India

4. Institute of Child Health and Hospital for Children, Chennai 600008, India

5. Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA

Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C), a sequela of severe acute respiratory syndrome coronavirus-2 infection (SARS-CoV2), has been progressively reported worldwide, with cardiac involvement being a frequent presentation. Although the clinical and immunological characteristics of MIS-C with and without cardiac involvement have been described, the immunological differences between cardiac and non-cardiac MIS-C are not well understood. Methods: The levels of type 1, type 2, type 17, other proinflammatory cytokines and CC chemokines and CXC chemokines were measured using the Magpix multiplex cytokine assay system in MIS-C children with MIS-C cardiac (MIS-C (C) (n = 88)) and MIS-C non-cardiac (MIS-C (NC) (n = 64)) abnormalities. Results: MIS-C children with cardiac manifestations presented with significantly increased levels of cytokines such as IFN-γ, IL-2, TNFα, IL-5, IL-1α, IL-1β, IL-6, IL-10 and IL-12p70 and chemokines such as CCL2, CCL3, CCL11 and CXCL10 in comparison to MIS-C children without cardiac manifestations. Clustering analysis revealed that cytokines and chemokines could clearly distinguish MIS-C children with and without cardiac manifestations. In addition, these responses significantly diminished and normalized 9 months after treatment. Conclusions: This is one of the first studies characterizing and differentiating systemic inflammation in MIS-C with and without cardiac involvement from a low- and middle-income country (LMIC). Our study contributes to the existing body of evidence and advances our knowledge of the immunopathogenesis of MIS-C in children.

Funder

Division of Intramural Research

National Institute of Allergy and Infectious Diseases

NIH-NIRT-ICER

Publisher

MDPI AG

Subject

Virology,Infectious Diseases

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