સીઓવીડ -19 સાથે સંકળાયેલ મલ્ટિસિસ્ટમ ઇન્ફ્લેમેટરી સિન્ડ્રોમ: શરૂઆતમાં કાવાસાકી સિન્ડ્રોમથી મૂંઝવણમાં, આ રોગને એમઆઈએસ-સી કહેવામાં આવે છે.

COVID-19, The difference between the Multisystem Inflammatory Syndrome and the Kawasaki syndrome

Discovered the mechanism that triggers severe બળતરા સિન્ડ્રોમ સાથે બાળકોમાં કોવિડ -19. Initially confused with કાવાસાકી સિન્ડ્રોમ, this systemic inflammatory disease caused in children by COVID-19 infection is called એમઆઈએસ-સી (બાળકોમાં મલ્ટિસિસ્ટમ ઇન્ફ્લેમેટરી સિન્ડ્રોમ).

ના સંશોધકો બામ્બિનો ગેસ હોસ્પિટલ have now been able to identify its immunological profile and recognizes how it works. The research carried out in collaboration with the સ્ટોકહોમમાં કેરોલિન્સ્કા ઇન્સ્ટિટ્યૂટ, opens the way to specific tests for early diagnosis and targeted treatments. The results have just been published in the scientific journal સેલ.

Multisystem Inflammatory Syndrome, the premises of research

ની શરૂઆતમાં કોવિડ -19 રોગચાળો, children seemed to be almost immune to the consequences of the new coronavirus.

Going on, however, it became evident that they too, although in a less serious way, could get sick with કોવિડ -19. In some cases, unfortunately, children can even develop a severe form of systemic inflammation, મલ્ટિસિસ્ટમ ઇન્ફ્લેમેટરી સિન્ડ્રોમ, a new disease that can occur after contracting the coronavirus.

Young patients with MIS-C show vasculitis (inflammation of blood vessels), heart and intestinal problems and a systemic increase in the inflammatory state. These characteristics are partly in common with another vasculitis – કાવાસાકી સિન્ડ્રોમ– which initially suggested a causal link between Kawasaki syndrome and SARS-Cov2 infection.

The CACTUS study explained the mechanism of the Multisystem Inflammatory Syndrome

The study ‘CACTUS – Immunological studies in children affected by COVID and acute diseases’ was developed by doctors and researchers of Bambino Gesù Hospital during the health emergency to try to understand the કોવિડ -19 રોગ બાળકમાં.

આ COVID-19 Center of Palidoro, the General Pediatrics group that in recent years has been dedicated to the study of કાવાસાકી સિન્ડ્રોમ, and the Clinical Immunology and Vaccinology group of the University Hospital Paediatric Department have collaborated in the research.

101 children were involved, of which 13 with COVID that developed the multisystemic inflammatory form, 41 with COVID, 28 with Kawasaki syndrome occurred in the pre-COVID era and 19 healthy.

The study of Bambino Gesù Hospital: the results 

In both diseases, Kawasaki and Multisystem Inflammatory Syndrome (MIS-C), an alteration in the levels of સાયટોકીન્સ (inflammation mediators) involved in the immune response were detected, but with differences: for example, interleukin 17a (IL-17a) was found to be particularly increased in children with Kawasaki syndrome but not in those with COVID-19 and MIS-C.

Compared to children with કાવાસાકી સિન્ડ્રોમ, સાથે દર્દીઓ Covid વિકાસશીલ મલ્ટિસિસ્ટમ ઇન્ફ્લેમેટરી સિન્ડ્રોમ have been found to have a high presence of autoantibodies, એટલે કે, એન્ટિબોડીઝ directed against particular portions of cardiac tissue or substances of the body itself, which act against two specific proteins (endoglin and RPBJ).

આ સ્વયંચાલિત can determine the vascular and cardiac damage typical of MIS-C. Also from a cellular point of view, substantial differences between the two pathologies have emerged. બાળકો થી પ્રભાવિત થવું COVID, in fact, have a particular type of T lymphocytes (a subtype of સફેદ રક્ત કોશિકાઓ for the defence of the body) with impaired immune function compared to children with કાવાસાકી રોગ.

This alteration is the basis of inflammation and the production of autoantibodies against the heart.

Prospects of researches on Multisystem Inflammatory Syndrome

The different indicators identified between the two diseases have made it possible to clarify the immunological mechanisms responsible for their development and will allow in the near future to develop specific laboratory tests to arrive at a certain and early diagnosis.

Monitoring T lymphocytes and the spectrum of antibodies in children affected by COVID-19 will allow diagnosing early those patients who are at risk of developing a form of એમઆઈએસ-સી.

“These results represent an important discovery also for a more accurate and evidence-based choice of protocols for the treatment of systemic inflammation related to સાર્સ-કોવી -2 ચેપ અને કાવાસાકી રોગ“, explains Dr Paolo Palma, head of Clinical Immunology and Vaccinology of the Child Jesus and the study.

Therapies for the Multisystem Inflammatory Syndrome

Research results indicate that high-dose immunoglobulins should be used to limit the effect of autoantibodies, anakinra (an immunosuppressive active ingredient that blocks interleukin-1 receptors) and cortisone should be used to treat children with the મલ્ટિસિસ્ટમ ઇન્ફ્લેમેટરી સિન્ડ્રોમ at an early stage to block inflammation secondary to vessel damage.

In contrast, the use of ટોસિલઝુમાબ (anti-IL6) and TNF-a blocking drugs is not recommended in pediatric patients. For patients with Kawasaki, the data suggest for the first time the potential efficacy of an IL-17 blocking drug (secukinumab) to control the inflammation underlying this disease.

વાંચો ઇટાલિયન લેખ

સોર્સ

www.dire.it