Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy.
Int J Mol Sci. 2022 Sep 3;23(17):10106. doi: 10.3390/ijms231710106.
Kawasaki Disease (KD) and Multisystem Inflammatory Syndrome in Children (MIS-C) are pediatric diseases characterized by systemic inflammation and vascular injury, potentially leading to coronary artery lesions (CALs). Data on vascular injury occurring during acute COVID-19 (AC19) in children are still lacking. The aim of our study was to investigate endothelial injury in KD-, MIS-C- and AC19-dosing circulating endothelial cells (CECs).
We conducted a multicenter prospective study. CECs were enumerated by CellSearch technology through the immunomagnetic capture of CD146-positive cells from whole blood.
We enrolled 9 KD, 20 MIS-C and 10 AC19. During the acute stage, the AC19 and KD patients had higher CECs levels than the MIS-C patients. From the acute to subacute phase, a significant CEC increase was observed in the KD patients, while a mild decrease was detected in the MIS-C patients. Cellular clusters/syncytia were more common in the KD patients. No correlation between CECs and CALs were found in the MIS-C patients. The incidence of CALs in the KD group was too low to investigate this correlation.
Our study suggests a possible role of CECs as biomarkers of systemic inflammation and endothelial dysfunction in KD and MIS-C and different mechanisms of vascular injury in these diseases. Further larger studies are needed.
川崎病（KD）和儿童多系统炎症综合征（MIS-C）是两种以全身炎症和血管损伤为特征的儿科疾病，可能导致冠状动脉损伤（CAL）。关于儿童急性 COVID-19（AC19）期间血管损伤的数据仍然缺乏。我们的研究目的是研究 KD、MIS-C 和 AC19 患儿中循环内皮细胞（CEC）的内皮损伤。
我们进行了一项多中心前瞻性研究。通过免疫磁捕获全血中的 CD146 阳性细胞，使用 CellSearch 技术计数 CECs。
我们纳入了 9 例 KD、20 例 MIS-C 和 10 例 AC19。在急性期，AC19 和 KD 患儿的 CECs 水平高于 MIS-C 患儿。从急性期到亚急性期，KD 患儿的 CEC 显著增加，而 MIS-C 患儿的 CEC 则轻度下降。KD 患儿中更常见细胞簇/合胞体。在 MIS-C 患儿中，CECs 与 CAL 之间无相关性。KD 组 CAL 的发生率太低，无法对此相关性进行研究。
我们的研究表明，CECs 可能作为 KD 和 MIS-C 全身炎症和内皮功能障碍的生物标志物，以及这些疾病中不同的血管损伤机制。需要进一步开展更大规模的研究。
