Severity and Cardiac Involvement in Multisystem Inflammatory Syndrome in Children

Multisystem infammatory syndrome in children (MIS-C) occurs secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A retrospective study, involving 6 tertiary-care centers in Haryana, was conducted to evaluate the clinical features, severity, laboratory fndings, and outcomes of patients with MIS-C. Disease severity was graded (mild/ moderate/severe) and presence of cardiac abnormalities noted. Patients with and without cardiac abnormalities and with and without severe disease were compared. Forty-eight children with MIS-C were included (median age - 9.5 y). Fever (100%), gastrointestinal (83.3%) and mucocutaneous (50%) symptoms were common. Only 16.7% patients had previous history of documented SARS-CoV-2 infection/contact. Severe disease and cardiac abnormalities were seen in 47.9% and 54.2% patients, respectively. NT-proBNP>1286.5 pg/mL and thrombocytopenia (?119500/µL) were signifcant risk factors for severe MIS-C. Forty-fve patients (93.8%) recovered and 3 died. Median hospitalization duration was 7 d (5–9.5). MIS-C must be considered as a possibility in any febrile child, even if a positive epidemiological history is absent. High NT-proBNP and thrombocytopenia are signifcant risk factors for severe MIS-C.

Purification and characterization of cathepsin Β from goat brain.

Cathepsin Β was purified to an apparent homogeneity from goat brain utilizing the techniques of homogenization, autolysis at pH 4, 30–70% (NH4)2SO4 fractionation, Sephadex G-100 column chromatography, organomercurial afinity chromatography and ion-exchange chromatography on CM-Sephadex C-50. The enzyme had a pH optima of 6 with α-N-benzoyl-D, L-arginine-ß-naphthIylamide, benzyloxycarbonyl-arginine-arginme-4- methoxy -ß-naphthylamide and azocasein as substrates. The Km values for the hydrolysis of α-N-benzoyl-D, L-arginine-ß-naphthylamide and benzyloxycarbonyl-arginine-arginine-4- methoxy -ß-naphthylamide were 2·36 and 0·29 mM respectively in 2·5% dimethylsulphoxide. However, the corresponding Km values for these substrates in 1 % dimethylsulphoxide were 0·51 and 0·09 mM. The enzyme was strongly inhibited by thiol inhibitors and tetrapeptidyl chloromethylketones. Leupeptin inhibited the enzyme competitively with Ki value of 12·5 × l0–9M. Dithioerythritol was found to be the most potent activator of this sulfhydryl protease. Molecular weight estimations on sodium dodecyl sulphatepolyacrylamide gel electrophoresis and on analytical Sephadex G-75 column were around 27,000 and 29,000 daltons respectively. Cathepsin Β was found to reside in the lysosomes of goat brain. The highest percentage of cathepsin Β was in cerebrum. However, the specific activity of the enzyme was maximum in pituitary gland.