When covid-19 appeared, doctors were eager to define and treat this new disease. They soon found that it was not the only new disease caused by sars-cov-2 Some children infected with the virus also developed abdominal pain, headache, rash and vomiting. This new series of symptoms is called childhood multisystem inflammatory syndrome (mis-c), and many children need intensive care
With the increasing prevalence of mis-c, doctors began to notice its similarity with Kawasaki disease (KD), a pre pandemic disease that has puzzled pediatricians for more than 50 years. Mis-c and KD have many common symptoms, including fever, rash and eye congestion, but KD can also lead to coronary aneurysms and heart attacks. Unlike mis-c, KD is associated with a specific virus, which may be triggered by various infectious and environmental stimuli.
To better understand the comparison of these inflammatory syndromes, researchers at the University of California, San Diego School of Medicine collected blood and tissue samples from patients with mis-c and KD. Using artificial intelligence tools, they analyzed the gene expression patterns in these two cases and compared them with covid-19 gene expression markers.
The study was led by Dr. pradipta Ghosh (left), Dr. Jane C. burns (Center) and Dr. debashis sahoo (right), researchers at the University of California, San Diego School of medicine. Source: Department of Health Sciences, University of California, San Diego
The results of the study, which will be published in the journal Nature communication today (May 16, 2022), show that mis-c and KD are in the same immune response continuum as covid-19, and mis-c is a more serious response version than KD. Despite these basic similarities, these conditions do differ on several laboratory and clinical parameters. The authors say these findings can improve disease diagnosis, monitoring and treatment in pediatric patients.
"We want our immune system to protect us from harmful stimuli, but some children are genetically prone to a stronger response, leading to systemic inflammation and unnecessary symptoms," said co-author Dr. Jane C. burns, a pediatrician at Reddy children's Hospital in San Diego and director of the Kawasaki Disease Research Center at the school of medicine at the University of California, San Diego. "The sooner we identify and understand the inflammatory status of children, the better we can adjust our life-saving support.".
The team previously identified a set of 166 genes expressed in viral respiratory diseases, including covid-19, a subset of which also corresponds to the severity of the disease. The researchers found that the same "gene signature" also applies to mis-c and KD, suggesting that these diseases stem from a similar potential mechanism, involving the rapid release of IL15 / il15ra cytokines.
The kd-mis team looked for a set of genes that could not be identified by the computer, and then looked for a set of genes that could not be identified by the computer.
"We didn't expect this," said co-author Dr pradipta Ghosh, a professor of medicine and cell and molecular medicine at the University of California, San Diego School of medicine. "We analyzed mis-c and KD through two different genetic characteristics. Both experiments tell us that these diseases are closely related, and these two genetic characteristics may represent different parts of the same broader immune response."
Although the study provides a new unified framework for these diseases, it also finds some subtle differences. For example, patients with mis-c have low platelet and eosinophil counts, which can be measured from routine blood tests. The level of kd-mis was higher in many of the selected samples than in several of the selected cells.
The authors note that treatments for some of these cytokines, including TNFa and IL1 ß, have been approved by the U.S. Food and Drug Administration (FDA) and are being tested as a new therapy for mis-c.
"We believe that our findings are likely to have an immediate impact on the planning of clinical trials and will also form clinical guidelines and patient care in the future," said Dr. debashis sahoo, co-author and associate professor of Pediatrics and computer science at the University of California, San Diego School of medicine and the Jacobs School of Engineering at the University of California, San Diego