Unmasking the Coronavirus Mystery in Kids: Epstein-Barr Virus Revealed as Potential Culprit Behind Severe Reactions
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Uncovered potential reason leading to severe COVID-19 responses in children - Possible reason for intense coronavirus response in children identified
In a groundbreaking study, researchers have shed light on the cause of severe inflammatory reactions in children, known as PIMs (Pediatric Inflammatory Multisystem Syndrome). PIMs, a life-threatening condition that can occur weeks after a coronavirus infection, has been found to be associated with the reactivation of another pathogen– the Epstein-Barr virus (EBV).
The Epstein-Barr virus typically is the culprit behind infectious mononucleosis, a disease known colloquially as the "kissing disease." Whilst the majority of people carry the pathogen without experiencing any symptoms, Around 90% of people are infected with the virus at some point in their lives, according to Berlin's Charité University Medicine. However, an infection may lead to flu-like symptoms, requiring several weeks to recover.
EBV Can Lay Dormant for Years
As stated by study author Tilmann Kallinich, a pediatric specialist in rheumatology at Charité, even after an acute infection with the Epstein-Barr virus, the virus continues to reside within the body, housing itself in various cells and persisting in humans for a lifetime. "It can reactivate years after the initial infection, particularly when the immune system is weakened," Kallinich explains.
Scientists have now identified this reactivation in children with PIMs. The study authors, including Mir-Farzin Mashreghi, an immunologist and deputy scientific director of the German Rheuma Research Center (DRFZ), observed that the children's immune systems, weakened by the coronavirus infection, could no longer keep the latent EBV infection at bay.
The study, published in The Lancet, examined 145 children aged 2 to 18, comparing those who had developed PIMs with children who had experienced a coronavirus infection but did not develop the syndrome. In around two-thirds of the children with PIMs, scientists found infected B-cells (a type of white blood cell) carrying the Epstein-Barr virus in their blood, while no such findings were present in the control group.
PIMS Patients Show Increased EBV-Specific T-Cells
All children with PIMs displayed an increase in EBV-specific T-cells, indicating that reactivation of the EBV was responsible for the children's illness. Furthermore, 80 percent of children with PIMS had EBV-specific antibodies, suggesting that the body had actively fought the infection, albeit unsuccessfully.
Researchers discovered that this failure was linked to an excessively high amount of a signaling molecule called TGFβ, which inhibits the function of immune cells, making them less effective against the Epstein-Barr virus and allowing the virus to replicate. As a result, the body produces more immune cells against the virus, but they remain non-functional.
This ultimately leads to an extreme inflammatory reaction that can damage organs and potentially be fatal.
Implications for Other COVID-19-Related Diseases
Mashreghi believes that the findings could also be relevant for other COVID-19-related diseases, such as Long COVID. There is evidence that the reactivation of latent viruses may play a role in Long COVID. "This could mean that there are parallels to the processes seen in PIMS, in which case TGFβ inhibitors could be potential candidates for a therapy against Long COVID," says Mashreghi.
In recent months, only sporadic PIMS cases have been reported, according to Markus Hufnagel from the German Society for Pediatric Infectious Diseases (DGPI). The high basic immunity within the population, including children, is likely a factor contributing to the decrease in cases. PIMS only occurs after a first contact with SARS-CoV-2. Additionally, it's possible that since autumn 2022, COVID-19 variants are less likely to stimulate the immune system, even with a first encounter with the virus.
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In the midnight hours, the lab was buzzing with intellectual energy as a team of top scientists raced against time to unveil the secrets behind PIMs. The fast-paced work often left crumpled papers, spilled coffee, and sleepless eyes across the lab tables.
Yet, as they teetered on the brink of discovery, their determination remained unwavering, fueled by the desire to help the little fighting warriors battling PIMs in hospitals worldwide. The research would undoubtedly change the landscape of understanding and treatment for the rare yet deadly condition.
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- The researchers have linked the reactivation of the Epstein-Barr virus (EBV) with the development of Pediatric Inflammatory Multisystem Syndrome (PIMS), a life-threatening condition associated with coronavirus infections.
- A study, published in The Lancet, shows that the reactivation of EBV occurs when the immune system, weakened by a coronavirus infection, fails to keep the latent virus dormant.
- The findings could have implications for other COVID-19-related diseases, such as Long COVID, as there is evidence that latent viral reactivation may play a role in these conditions, making TGFβ inhibitors potential candidates for a therapy against Long COVID.
