| Syrimi, Eleni, Fennell, Eanna, Richter, Alex, Vrljicak, Pavle, Stark, Richard, Ott, Sascha, Murray, Paul G., Al-Abadi, Eslam, Chikermane, Ashish, Dawson, Pamela, Hackett, Scott, Jyothish, Deepthi, Kanthimathinathan, Hari Krishnan, Monaghan, Sean, Nagakumar, Prasad, Scholefield, Barnaby R., Welch, Steven, Khan, Naeem, Faustini, Sian, Davies, Kate  ORCID: https://orcid.org/0000-0002-9807-1231, Zelek, Wioleta M., Kearns, Pamela and Taylor, Graham S.
      2021.
      
      The immune landscape of SARS-CoV-2-associated multisystem inflammatory syndrome in children (MIS-C) from acute disease to recovery.
      iScience
      24
      
        (11)
      
      
      , 103215.
      10.1016/j.isci.2021.103215   | 
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Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening disease occurring several weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Deep immune profiling showed acute MIS-C patients had highly activated neutrophils, classical monocytes and memory CD8+ T-cells, with increased frequencies of B-cell plasmablasts and double-negative B-cells. Post treatment samples from the same patients, taken during symptom resolution, identified recovery-associated immune features including increased monocyte CD163 levels, emergence of a new population of immature neutrophils and, in some patients, transiently increased plasma arginase. Plasma profiling identified multiple features shared by MIS-C, Kawasaki Disease and COVID-19 and that therapeutic inhibition of IL-6 may be preferable to IL-1 or TNF-α. We identified several potential mechanisms of action for IVIG, the most commonly used drug to treat MIS-C. Finally, we showed systemic complement activation with high plasma C5b-9 levels is common in MIS-C suggesting complement inhibitors could be used to treat the disease.
| Item Type: | Article | 
|---|---|
| Date Type: | Publication | 
| Status: | Published | 
| Schools: | Schools > Medicine | 
| Additional Information: | Creative Commons Attribution 4.0 International (CC BY 4.0) | 
| Publisher: | Cell Press | 
| ISSN: | 2589-0042 | 
| Date of First Compliant Deposit: | 18 November 2021 | 
| Date of Acceptance: | 26 September 2021 | 
| Last Modified: | 26 Aug 2025 10:18 | 
| URI: | https://orca.cardiff.ac.uk/id/eprint/145592 | 
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