接种疫苗
2019年冠状病毒病(COVID-19)
急性心肌炎
心肌炎
病毒学
免疫学
医学
病理
内科学
疾病
传染病(医学专业)
作者
Hing Wai Tsang,Mike Yat Wah Kwan,Gilbert T. Chua,Sabrina Tsao,Joshua Sung Chih Wong,Keith T. S. Tung,Godfrey Chi Fung Chan,Kelvin Kai-Wang To,Ian C. K. Wong,Wing Leung,Patrick Ip
出处
期刊:Med
[Elsevier]
日期:2024-03-01
标识
DOI:10.1016/j.medj.2024.02.008
摘要
Summary
Background
Vaccine-related acute myocarditis is recognized as a rare and specific vaccine complication following mRNA-based COVID-19 vaccinations. The precise mechanisms remain unclear. We hypothesized that natural killer (NK) cells play a central role in its pathogenesis. Methods
Samples from 60 adolescents with vaccine-related myocarditis were analyzed, including pro-inflammatory cytokines, cardiac troponin T, genotyping, and immunophenotyping of the corresponding activation subsets of NK cells, monocytes, and T cells. Results were compared with samples from 10 vaccinated individuals without myocarditis and 10 healthy controls. Findings
Phenotypically, high levels of serum cytokines pivotal for NK cells, including interleukin-1β (IL-1β), interferon α2 (IFN-α2), IL-12, and IFN-γ, were observed in post-vaccination patients with myocarditis, who also had high percentage of CD57+ NK cells in blood, which in turn correlated positively with elevated levels of cardiac troponin T. Abundance of the CD57+ NK subset was particularly prominent in males and in those after the second dose of vaccination. Genotypically, killer cell immunoglobulin-like receptor (KIR) KIR2DL5B(−)/KIR2DS3(+)/KIR2DS5(−)/KIR2DS4del(+) was a risk haplotype, in addition to single-nucleotide polymorphisms related to the NK cell-specific expression quantitative trait loci DNAM-1 and FuT11, which also correlated with cardiac troponin T levels in post-vaccination patients with myocarditis. Conclusion
Collectively, these data suggest that NK cell activation by mRNA COVID-19 vaccine contributed to the pathogenesis of acute myocarditis in genetically and epidemiologically vulnerable subjects. Funding
This work was funded by the Hong Kong Collaborative Research Fund (CRF) 2020/21 and the CRF Coronavirus and Novel Infectious Diseases Research Exercises (reference no. C7149-20G).
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