Proteomic Profiling of MIS-C Patients Reveals Heterogeneity Relating to Interferon Gamma Dysregulation and Vascular Endothelial Dysfunction
Caroline Diorio; Rawan Shraim; Laura A Vella; Josephine R Giles; Amy E Baxter; Derek A Oldridge; Scott W Canna; Sarah E Henrickson; Kevin O McNerney; Frances Balamuth; Chakkapong Burudpakdee; Jessica Lee; Tomas Leng; Alvin Farrel; Michele P Lambert; Kathleen E Sullivan; E. John Wherry; David T Teachey; Hamid Bassiri; Edward M Behrens.
Preprint
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| PREPRINT-MEDRXIV | ID: ppmedrxiv-21255439
Multi-system Inflammatory Syndrome in Children (MIS-C) is a major complication of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic in pediatric patients. Weeks after an often mild or asymptomatic initial infection with SARS-CoV-2 children may present with a severe shock-like picture and marked inflammation. Children with MIS-C present with varying degrees of cardiovascular and hyperinflammatory symptoms. We performed a comprehensive analysis of the plasma proteome of more than 1400 proteins in children with SARS-CoV-2. We hypothesized that the proteome would reflect heterogeneity in hyperinflammation and vascular injury, and further identify pathogenic mediators of disease. Protein signatures demonstrated overlap between MIS-C, and the inflammatory syndromes macrophage activation syndrome (MAS) and thrombotic microangiopathy (TMA). We demonstrate that PLA2G2A is a key marker of MIS-C that associates with TMA. We found that IFN{gamma} responses are dysregulated in MIS-C patients, and that IFN{gamma} levels delineate clinical heterogeneity.
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