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儿童炎症性多系统综合征(PIMS)——细胞因子如白细胞介素-6的潜在作用。

Pediatric Inflammatory Multisystem Syndrome (PIMS) - Potential role for cytokines such Is IL-6.

作者信息

Lacina L, Brábek J, Fingerhutová Š, Zeman J, Smetana K

机构信息

Charles University, First Faculty of Medicine, Institute of Anatomy, Prague, Czech Republic.

出版信息

Physiol Res. 2021 Apr 30;70(2):153-159. doi: 10.33549/physiolres.934673.

Abstract

COVID-19 is a transmissible respiratory disease caused by coronavirus SARS-CoV-2, which is similar to SARS or MERS. Its increased severity was noted in aged patients usually over 65 years of age. Children and young people have an asymptomatic or mild course of the disease.Unfortunately, the number of children with problems after mild or asymptomatic COVID-19 recovery is increasing and their troubles resemble Kawasaki disease, although the laboratory findings seem to be different. This condition is called pediatric inflammatory multisystem syndrome (PIMS), and it is a new disease seen in children directly influenced by previous SARS-CoV-2 infection. The literature reports that PIMS typically follows 2-4 weeks after SARS-CoV-2 infection. The clinical symptoms of the affected children are extremely complex, ranging from gastrointestinal to cardiovascular problems with frequent skin and mucosal manifestations, and without intensive treatment they can be fatal. The exact causes of PIMS are recently unknown, however, it is explained as hyperactivation of immunity.In this minireview, we summarize data on the prominent role of the IL-6-IL-6R-STAT3 axis in PIMS aetiopathogenesis. Therapeutic manipulation of IL-6 or IL-6 receptor could be an approach to the treatment of children with severe PIMS.

摘要

新冠肺炎是一种由冠状病毒SARS-CoV-2引起的可传播的呼吸道疾病,该病毒与SARS或中东呼吸综合征相似。通常在65岁以上的老年患者中,其严重程度会增加。儿童和年轻人感染该疾病后通常无症状或症状较轻。不幸的是,轻症或无症状新冠肺炎康复后出现问题的儿童数量正在增加,他们的症状类似于川崎病,尽管实验室检查结果似乎有所不同。这种情况被称为儿童炎症性多系统综合征(PIMS),是一种在直接受先前SARS-CoV-2感染影响的儿童中出现的新疾病。文献报道,PIMS通常在感染SARS-CoV-2后2至4周出现。受影响儿童的临床症状极其复杂,从胃肠道问题到心血管问题,经常伴有皮肤和黏膜表现,若不进行强化治疗,可能会致命。PIMS的确切病因目前尚不清楚,不过,有人解释这是免疫过度激活所致。在这篇小型综述中,我们总结了关于IL-6-IL-6R-STAT3轴在PIMS发病机制中的重要作用的数据。对IL-6或IL-6受体进行治疗性干预可能是治疗重症PIMS患儿的一种方法。

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