Division of Genetics, Department of Medicine, Howard Hughes Medical Institute, Brigham and Women's Hospital, Boston, MA 02115, USA.
Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.
Sci Transl Med. 2023 Jul 26;15(706):eadh9917. doi: 10.1126/scitranslmed.adh9917.
Severe acute hepatitis of unknown etiology in children is under investigation in 35 countries. Although several potential etiologic agents have been investigated, a clear cause for the liver damage observed in these cases remains to be identified. Using VirScan, a high-throughput antibody profiling technology, we probed the antibody repertoires of nine cases of severe acute hepatitis of unknown etiology treated at Children's of Alabama and compared their antibody responses with 38 pediatric and 470 adult controls. We report increased adeno-associated dependoparvovirus A (AAV-A) breadth in cases relative to controls and adeno-associated virus 2 (AAV-2) peptide responses that were conserved in seven of nine cases but rarely observed in pediatric and adult controls. These findings suggest that AAV-2 is a likely etiologic agent of severe acute hepatitis of unknown etiology.
35 个国家正在调查儿童不明病因的严重急性肝炎。尽管已经研究了几种潜在的病因，但这些病例中观察到的肝损伤的明确原因仍有待确定。使用高通量抗体分析技术 VirScan，我们对在阿拉巴马州儿童医疗中心治疗的 9 例不明病因的严重急性肝炎患者的抗体库进行了探测，并将他们的抗体反应与 38 例儿科患者和 470 例成人对照组进行了比较。我们报告说，与对照组相比，病例中的腺相关依赖细小病毒 A（AAV-A）广度增加，并且在 9 例中的 7 例中观察到腺相关病毒 2（AAV-2）肽反应保守，但在儿科和成人对照组中很少观察到。这些发现表明，AAV-2 可能是不明病因的严重急性肝炎的病因。
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