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The recent outbreak of acute severe hepatitis in children of unknown origin - what is known so far

Recent studies have reported that pediatric acute liver failure of unknown origin is immune-mediated, with CD8+ T cells playing a key role. Moreover, investigation of superantigen-mediated T-cell activation by the SARS-CoV-2 spike protein in pediatric severe acute hepatitis is needed in the context...

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Main Authors: Lurz, Eberhard (Author) , Lenz, Dominic (Author) , Bufler, Philip (Author) , Fichtner, Alexander (Author) , Henning, Stephan (Author) , Jankofsky, Martin (Author) , Kathemann, Simone (Author) , Melter, Michael (Author) , Oh, Jun (Author) , Pfister, Eva Doreen (Author) , Sturm, Ekkehard (Author) , Knoppke, Birgit (Author) , Lainka, Elke (Author)
Format: Article (Journal) Editorial
Language:English
Published: [October 2022]
In: Journal of hepatology
Year: 2022, Volume: 77, Issue: 4, Pages: 1214-1215
ISSN:1600-0641
DOI:10.1016/j.jhep.2022.05.039
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jhep.2022.05.039
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0168827822003634
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Author Notes:Eberhard Lurz, Dominic Lenz, Philip Bufler, Alexander Fichtner, Stephan Henning, Martin Jankofsky, Simone Kathemann, Michael Melter, Jun Oh, Eva Doreen Pfister, Ekkehard Sturm, Birgit Knoppke, Elke Lainka
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Summary:Recent studies have reported that pediatric acute liver failure of unknown origin is immune-mediated, with CD8+ T cells playing a key role. Moreover, investigation of superantigen-mediated T-cell activation by the SARS-CoV-2 spike protein in pediatric severe acute hepatitis is needed in the context of the proposed mechanism of multisystem inflammatory syndrome in children (MIS-C). We investigated the immunological characteristics of a Japanese pediatric patient with severe acute hepatitis post SARS-CoV-2 infection. The patient demonstrated autoimmune hepatitis-like liver histology with CD8+ lymphocyte-predominant infiltration. There was Th1-type immune skewing, including remarkable peripheral CD8+ T-cell activation and a skewed T cell receptor repertoire. We also found elevated plasma levels of the anti-SARS-CoV-2 spike-specific IgG antibody, and the titer peaked after treatment, as seen with MIS-C. These findings support that immunological activation involving SARS-CoV-2 spike protein plays a crucial role in a pediatric patient with acute severe hepatitis post SARS-CoV-2 infection.
Item Description:Gesehen am 18.01.2023
Physical Description:Online Resource
ISSN:1600-0641
DOI:10.1016/j.jhep.2022.05.039

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