Multisystem inflammatory syndrome in children characterized by enhanced antigen-specific T-cell expression of cytokines and its reversal following recovery

Figure 1. Children with MIS show enhanced frequencies of SARS-CoV-2-specific CD4+ Th1 and Th17 cells. The net frequencies of Th1 and Th17 cytokines by CD4+ T cells with or without SARS-CoV-2-antigenic stimulation were compared statistically among MIS-C, children with COVID-19, and other infectious diseases. (A) CD4+ T cells at baseline or no stimulation; (B) CD4+ T cells at SARS-CoV S-RBD stimulation; (C) CD4+ T cells at SARS-CoV ICL stimulation; and (D) CD4+ T cells at M.tb WCL stimulation. Each circle in the scatter plot represents a single variable from an individual and the line at the center of the scatter plot is the geometric mean. The p-values were calculated using the Kruskal–Wallis test to show the significance and were represented as *, **, ***, and ****.

Figure 2. Children with MIS show enhanced frequencies of SARS-CoV-2-specific CD8+ Tc1 and Tc17 cells. The net frequencies of Tc1 and Tc17 cytokines by CD8+ T cells with or without SARS-CoV-2-antigenic stimulation were compared statistically among children with MIS, COVID-19, and other infectious diseases. (A) CD8+ T cells at baseline or no stimulation; (B) CD8+ T cells at SARS-CoV S-RBD stimulation; (C) CD8+ T cells at SARS-CoV ICL stimulation; and (D) CD8+ T cells at M.tb WCL stimulation. Each circle in the scatter plot represents a single variable from an individual and the line at the center of the scatter plot is the geometric mean. The p-values were calculated using the Kruskal–Wallis test to show the significance and were represented as *, **, ***, and ****.

Figure 3. A signature profile of CD4+ T. (A) Cells expressing Th1/17 cytokines and CD8+ T. (B) Cells expressing Tc1/17 cytokines upon SARS-CoV-2-specific antigen stimulation in MIS-C, children with COVID-19, and children with other infectious diseases.

Figure 4. (A) Children with MIS show diminished frequencies of SARS-CoV-2-specific CD4+ Th1 and Th17 cells after treatment. The net frequencies of Th1 and Th17 cytokines by CD4+ T cells with or without SARS-CoV-2 antigenic stimulation were compared statistically between pre- and post-treatment of MIS-C. (Top) CD4+ T cells at baseline or no stimulation; (Middle) CD4+ T cells at SARS-CoV S-RBD stimulation; and (Bottom) CD4+ T cells at SARS-CoV ICL stimulation. Each circle in the scatter plot represents a single variable from an individual and the line connecting to the circle of the same individual from pre- to post-treatment. The p-values were calculated using the Wilcoxon test for matched pairs. (B) Children with MIS show diminished frequencies of SARS-CoV-2-specific CD8+ Tc1 and Tc17 cells after treatment. The net frequencies of Tc1 and Tc17 cytokines by CD8+ T cells with or without SARS-CoV-2 antigenic stimulation were compared statistically between pre- and post-treatment of MIS-C. (Top) CD8+ T cells at baseline or no stimulation; (Middle) CD8+ T cells at SARS-CoV S-RBD stimulation; and (Bottom) CD8+ T cells at SARS-CoV ICL stimulation. Each circle in the scatter plot represents a…