Petrarca Laura, Manganelli Valeria, Nenna Raffaella, Frassanito Antonella, Ben David Shira, Mancino Enrica, Garofalo Tina, Sorice Maurizio, Misasi Roberta, Midulla Fabio
Maternal Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy.
Translational and Precision Medicine Department, Sapienza University of Rome, Rome, Italy.
Front Pediatr. 2022 Apr 26;10:868269. doi: 10.3389/fped.2022.868269. eCollection 2022.
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, a novel syndrome known as a multisystem inflammatory syndrome in children (MIS-C) was reported in previously healthy children. A possible pro-inflammatory molecule, high-mobility group box 1 (HMGB1), may be assumed to play an important role in the pathogenesis and clinical presentation of MIS-C. We described the clinical picture of patients with MIS-C and we also aimed to test and compare HMGB1 serum levels of MIS-C patients with those of patients with previous SARS-CoV2 infection and healthy children.
We determined HMGB1 levels by Western blot in 46 patients and divided them into three groups, namely, five patients with MIS-C (median age: 8.36 years), 20 children with a history of SARS-CoV-2 infection (median age: 10.45 years), and 21 healthy children (controls) (median age: 4.84 years), without evidence of respiratory infection in the last 3 months.
The median level of HMGB1 in the serum of five patients with MIS-C was found to be significantly higher compared with both patients with a recent history of COVID-19 (1,151.38 vs. 545.90 densitometric units (DU), = 0.001) and control (1,151.38 vs. 320.33 DU, = 0.001) groups. The HMGB1 level in MIS-C patients with coronary involvement had a slightly higher value with respect to patients without coronary dilatation (1,225.36 vs. 1,030.49 DU, = 0.248). In two of the five children with MIS-C that performed a follow-up, the HMGB1 value decreased to levels that were superimposable to the ones of the control group.
The significantly high level of HMGB1 protein found in the serum of COVID-19 and patients with MIS-C supports its involvement in inflammatory manifestations, suggesting HMGB1 as a potential biomarker and therapeutic target in patients with severe illness.
自2019冠状病毒病（COVID-19）大流行开始以来，在先前健康的儿童中报告了一种称为儿童多系统炎症综合征（MIS-C）的新型综合征。一种可能的促炎分子，即高迁移率族蛋白B1（HMGB1），可能在MIS-C的发病机制和临床表现中起重要作用。我们描述了MIS-C患者的临床情况，并且还旨在检测和比较MIS-C患者与先前感染过SARS-CoV2的患者以及健康儿童的血清HMGB1水平。
我们通过蛋白质印迹法测定了46例患者的HMGB1水平，并将他们分为三组，即5例MIS-C患者（中位年龄：8.36岁）、20例有SARS-CoV-2感染史的儿童（中位年龄：10.45岁）和21例健康儿童（对照组）（中位年龄：4.84岁），这些健康儿童在过去3个月内无呼吸道感染证据。
发现5例MIS-C患者血清中HMGB1的中位水平与近期有COVID-19病史的患者（1151.38对545.90光密度单位（DU），P = 0.001）和对照组（1151.38对320.33 DU，P = 0.001）相比均显著更高。有冠状动脉受累的MIS-C患者的HMGB1水平相对于无冠状动脉扩张的患者略高（1225.36对1030.49 DU，P = 0.248）。在接受随访的5例MIS-C儿童中的2例中，HMGB1值降至与对照组相当的水平。
在COVID-19患者和MIS-C患者血清中发现的HMGB1蛋白水平显著升高，支持其参与炎症表现，提示HMGB1作为重症患者的潜在生物标志物和治疗靶点。
