Gelzo Monica, Giannattasio Antonietta, Maglione Marco, Muzzica Stefania, D'Anna Carolina, Scialò Filippo, Gagliardo Thaililja, Grieco Michela, Tipo Vincenzo, Castaldo Giuseppe
CEINGE-Biotecnologie Avanzate, Scarl, 80145 Naples, Italy.
Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy.
Metabolites. 2022 Jul 24;12(8):680. doi: 10.3390/metabo12080680.
Endothelial hyperinflammation and vasculitis are known hallmarks of acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C). They are due to the direct effect of the virus on endothelial cells enhanced by pro-inflammatory modulators and may cause venous/arterial thrombosis. Therefore, it is essential to identify patients with endothelial damage early in order to establish specific therapies. We studied the monocyte chemoattractant protein 1 (MCP-1), the perinuclear anti-neutrophil cytoplasmic antibodies (pANCA), and the vascular endothelial growth factor A (VEGF-A) in serum from 45 MIS-C patients at hospital admission and 24 healthy controls (HC). For 13/45 MIS-C patients, we measured the three serum biomarkers also after one week from hospitalization. At admission, MIS-C patients had significantly higher levels of MCP-1 and VEGF-A than the HC, but no significant differences were observed for pANCA. While after one week, MCP-1 was significantly lower, pANCA was higher and VEGF-A levels were not significantly different from the admission values. These findings suggest an involvement of epithelium in MIS-C with an acute phase, showing high MCP-1 and VEGF-A, followed by an increase in pANCA that suggests a vasculitis development. The serum biomarker levels may help to drive personalized therapies in these phases with anticoagulant prophylaxis, immunomodulators, and/or anti-angiogenic drugs.
内皮细胞高度炎症和血管炎是儿童急性冠状病毒病（COVID-19）和儿童多系统炎症综合征（MIS-C）的已知特征。它们是病毒对内皮细胞的直接作用，并由促炎调节剂增强，可能导致静脉/动脉血栓形成。因此，早期识别内皮损伤患者以建立特异性治疗至关重要。我们研究了45例MIS-C患者入院时血清中的单核细胞趋化蛋白1（MCP-1）、核周抗中性粒细胞胞浆抗体（pANCA）和血管内皮生长因子A（VEGF-A），并与24名健康对照者（HC）进行比较。对于13/45例MIS-C患者，我们在住院一周后也测量了这三种血清生物标志物。入院时，MIS-C患者的MCP-1和VEGF-A水平显著高于HC，但pANCA无显著差异。而一周后，MCP-1显著降低，pANCA升高，VEGF-A水平与入院时无显著差异。这些发现表明，MIS-C急性期存在上皮细胞参与，表现为MCP-1和VEGF-A升高，随后pANCA升高提示血管炎的发展。血清生物标志物水平可能有助于在这些阶段通过抗凝预防、免疫调节剂和/或抗血管生成药物推动个性化治疗。
