Infectious Diseases and Chemotherapy Research Laboratory, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens 11527, Greece.
Int J Mol Sci. 2023 Mar 16;24(6):5711. doi: 10.3390/ijms24065711.
Immune responses following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children are still under investigation. Even though coronavirus disease 2019 (COVID-19) is usually mild in the pediatric population, some children exhibit severe clinical manifestations, require hospitalization, or develop the most severe condition: a multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection. The activated innate, humoral and T-cell-mediated immunological pathways that lead certain pediatric populations to present with MIS-C or remain asymptomatic after SARS-CoV-2 infection are yet to be established. This review focuses on the immunological aspects of MIS-C with respect to innate, humoral, and cellular immunity. In addition, presents the role of the SARS-CoV-2 Spike protein as a superantigen in the pathophysiological mechanisms, discusses the great heterogeneity among the immunological studies in the pediatric population, and highlights possible reasons why some children with a certain genetic background present with MIS-C.
儿童感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 后的免疫反应仍在研究中。尽管儿童中的 2019 年冠状病毒病 (COVID-19) 通常较轻，但有些儿童表现出严重的临床症状，需要住院治疗，或发展为最严重的情况：与 SARS-CoV-2 感染相关的儿童多系统炎症综合征 (MIS-C)。导致某些儿科人群出现 MIS-C 或在感染 SARS-CoV-2 后仍无症状的先天、体液和 T 细胞介导的免疫途径尚未确定。这篇综述重点介绍了与先天、体液和细胞免疫有关的 MIS-C 的免疫学方面。此外，还介绍了 SARS-CoV-2 刺突蛋白作为超抗原在病理生理机制中的作用，讨论了儿科人群中免疫研究的巨大异质性，并强调了为什么某些具有特定遗传背景的儿童会出现 MIS-C 的可能原因。
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