Transient anti-cytokine autoantibodies superimpose the hyperinflammatory response in Kawasaki disease and multisystem inflammatory syndrome in children: a comparative cohort study on correlates of disease

• DOI: 10.1016/j.ebiom.2023.104736
• Publication Date: 2023-07-29T22:33:57Z
• Authors: Stejara A. Netea; Giske Biesbroek; Diana van Stijn; Hanna Ijspeert; Caspar I. van der...; Machiel H. Jansen; Judy Geissler; J.M. (Merlijn) va...; Martijn van der Kuip; Mariken P. Gruppen; Dieneke Schonenbe...; Berber Kapitein; A.M. (Marceline) ...; Sietse Q. Nagelkerke; Dasja Pajkrt; Frans B. Plötz; M.E.J. (Lisette) ...; Gijs W. Landman; Marlies A. van Ho...; Ines Goetschalckx; Erik J.M. Toonen; Frank L. van de V...; Irene M. Kuipers; Willem A. Dik; Taco W. Kuijpers; T. Hendriks; M.K. Felderhof; N.M. Weggelaar; L. Filippini; L. Rozendaal; M. Groeneweg; R. Nuboer; M. Bruijn; K.M. Dolman; J.G. Noordzij; J.P. de Winter; A.M. Vlieger; F.B. Plötz; L.C. Delemarre
• Keywords: Endothelial Activation

Children with SARS-CoV-2 related Multisystem Inflammatory Syndrome in (MIS-C) often present clinical features that resemble Kawasaki disease (KD). Disease severity adult COVID-19 is associated to the presence of anti-cytokine autoantibodies (ACAAs) against type I interferons. Similarly, ACAAs may be implicated KD and MIS-C. Therefore, we explored immunological response, correlates both disorders.Eighteen inflammatory plasma protein levels seven were measured (n = 216) MIS-C 56) longitudinally by Luminex and/or ELISA. Levels (up 1 year post-onset) these proteins data compared healthy paediatric controls.ACAAs found patient groups. The lagged behind peaked subacute phase. mostly directed IFN-γ (>80%) partially neutralising at best. presented a higher variety than Increased anti-IL-17A (P 0·02) anti-IL-22 0·01) inversely ICU admission Except for CXCL10 0·002), elevated Endothelial angiopoietin-2 coronary artery aneurysms 0·02); sCD25 0·009), 0·001), soluble IL-33-receptor (ST2, P MIS-C.Markers endothelial activation (E-selectin, angiopoietin-2), innate adaptive immune responses (macrophages [CD163, G-CSF], neutrophils [lipocalin-2], T cells [IFN-γ, CXCL10, IL-6, IL-17]), are upregulated detected diseases and, although only partly neutralising, their transient increased non-ICU patients suggest dampening role on inflammation.The study funded Dutch foundation Fonds Kind & Handicap an anonymous donor. sponsors had no design, analysis, or decision publication.