An Artificial Intelligence-guided signature reveals the shared host immune response in MIS-C and Kawasaki disease

Pradipta Ghosh (), Gajanan D. Katkar, Chisato Shimizu, Jihoon Kim, Soni Khandelwal, Adriana H. Tremoulet, John T. Kanegaye, Joseph Bocchini, Soumita Das, Jane C. Burns () and Debashis Sahoo ()
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Pradipta Ghosh: University of California San Diego
Gajanan D. Katkar: University of California San Diego
Chisato Shimizu: University of California San Diego
Jihoon Kim: University of California San Diego
Soni Khandelwal: University of California San Diego
Adriana H. Tremoulet: University of California San Diego
John T. Kanegaye: University of California San Diego
Joseph Bocchini: Willis-Knighton Health System
Soumita Das: University of California
Jane C. Burns: University of California San Diego
Debashis Sahoo: University of California San Diego

Nature Communications, 2022, vol. 13, issue 1, 1-18

Abstract: Abstract Multisystem inflammatory syndrome in children (MIS-C) is an illness that emerged amidst the COVID-19 pandemic but shares many clinical features with the pre-pandemic syndrome of Kawasaki disease (KD). Here we compare the two syndromes using a computational toolbox of two gene signatures that were developed in the context of SARS-CoV-2 infection, i.e., the viral pandemic (ViP) and severe-ViP signatures and a 13-transcript signature previously demonstrated to be diagnostic for KD, and validated our findings in whole blood RNA sequences, serum cytokines, and formalin fixed heart tissues. Results show that KD and MIS-C are on the same continuum of the host immune response as COVID-19. Both the pediatric syndromes converge upon an IL15/IL15RA-centric cytokine storm, suggestive of shared proximal pathways of immunopathogenesis; however, they diverge in other laboratory parameters and cardiac phenotypes. The ViP signatures reveal unique targetable cytokine pathways in MIS-C, place MIS-C farther along in the spectrum in severity compared to KD and pinpoint key clinical (reduced cardiac function) and laboratory (thrombocytopenia and eosinopenia) parameters that can be useful to monitor severity.

Date: 2022
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DOI: 10.1038/s41467-022-30357-w

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