The Association of RNase L, Cytokines, and Chemokines With Severity of Multisystem Inflammatory Syndrome in Children.
Journal
Journal of medical virology
Journal Volume
97
Journal Issue
10
Start Page
Article number e70650
ISSN
1096-9071
Date Issued
2025-10
Author(s)
Yen, Ting-Yu
Tan, Boon Fatt
Chang, Tu-Hsuan
Abstract
The 2',5'-oligoadenylate synthetase (OAS)-ribonuclease L (RNase L) system, induced by type I interferons, defends against RNA viruses. Inborn errors in this pathway may trigger inflammatory cytokines, contributing to SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C). This study examined circulating RNase L, cytokines, and chemokines in MIS-C. A prospective multicenter cohort study conducted in Taiwan from 2022 to 2023 recruited children with MIS-C, age- and gender-matched children with mild COVID-19, and healthy controls. Plasma cytokines, chemokines, and RNase L levels were measured, and clinical severity was analyzed. Among 108 children (63 boys and 45 girls), cytokine and chemokine levels positively correlated with disease severity, while RNase L levels were negatively correlated. IL-17A > 8.9 pg/mL and RNase L < 3.6 μg/mL differentiated MIS-C from mild COVID-19 (83% sensitivity, 94% specificity). CXCL9/MIG > 1129 pg/mL and RNase L < 2.8 μg/mL distinguished MIS-C patients with and without shock (79% sensitivity, 91% specificity). Findings reveal a systemic inflammatory signature in MIS-C, with pro-inflammatory, T cell activation, regulatory, and anti-inflammatory responses. Elevated IL-17A and CXCL9/MIG and decreased RNase L levels serve as sensitive biomarkers of MIS-C and disease severity.
Subjects
MIS‐C
RNase L
chemokines
children
cytokines
SDGs
Type
journal article