The new coronavirus has not yet disappeared, and the unexplained hepatitis of children has hit again, which has ignited the original anxiety.
According to the European Centre for Disease Control and Prevention[1], 450 cases have been reported worldwide, affecting 27 countries and regions, with the UK and the US the most.
Of the 11 confirmed deaths, 5 in Indonesia, 1 in Palestine, and 5 in the United States.
The current figures may be just the tip of the iceberg, as many countries are just beginning to ramp up surveillance for this unexplained childhood case of acute hepatitis.
Our country has also carried out corresponding monitoring.
Most children have early gastrointestinal symptoms, which later progress to jaundice and, in some cases, acute liver failure.
The international authoritative academic journal “The Lancet Gastroenterology and Hepatology” published the latest research: May be related to superantigens caused by new coronavirus infection.
Photo | Guangdong Radio and Television News
What are superantigens? What is the link between the new coronavirus and unexplained childhood hepatitis?
Medical Code specially invited authoritative experts to try to explain what the report said and how to understand it from a popular perspective.
Although published in authoritative journals, the paper does not equal the final conclusion
The authors of this paper are Petter Brodin, Professor, Department of Immunology and Inflammation, Imperial College London, and Paediatrics, Infectious Diseases and Immunology, Cedars Sinai Medical Center, Los Angeles, CA, USA Moshe Arditi of the Faculty.
Figure | Reference [2]
The attribute of the paper they published: communication paper [2], meaning: this is not original research, it is more of a guess by the author, but it needs to be further confirmed.
According to the current report and the data, the author first made a hypothesis of the result, and then went to the argument and came to the following conclusion:
Acute childhood unexplained hepatitis is the result of adenovirus infection and intestinal malnutrition in children previously infected with SARS-CoV-2 and carrying the viral reservoir.
Figure | Reference [2]
In other words, the new coronavirus is the main cause of acute unexplained children in children, but adenovirus infection intensifies this process, which has led to the current increase in children with unexplained hepatitis.
What are the superantigens and multisystem inflammatory syndrome in children mentioned in the report?
Professor Peter, one of the authors, once reviewed a review in the journal immunity[3], which analyzed the characteristics of children infected with the new coronavirus, and proposed a childhood multisystem inflammatory syndrome strong>, let me “translate” it for everyone:
COVID-19 “invades” children and lives longer in their guts, creating a “reservoir” of viruses in the gut where they are eliminated from infectivity.
It can be understood that it is not a “live virus” after entering the intestine, so there is no need to worry about infection.
But the virus in the viral reservoir is active and continues to repeatedly release proteins.
Immune cells in the gut will recognize proteins as foreign invading substances and perform the function of guarding the body to fight back against them, thus triggering an immune response in the gut.
At the same time, the gut will also release a “zonulin” substance, which increases the permeability of the gut, but also allows the viral proteins in the gut to enter the bloodstream.
This is where the trouble is, viral proteins that enter the bloodstream can cause inflammation in some of the body’s organs, such as: lungs, kidneys, skin, eyes, stomach, liver.
This is what multisystem inflammatory syndrome in children means. And one of the “murderers” of children with multisystem inflammatory syndrome is: superantigens.
This is easy to understand if we understand superantigens as super instructors:
T cells are the fighters that protect us from invading disease, but they need to be activated by antigenic stimulation and then begin to fight.
Superantigens can be understood as “super instructors” and do not require a certain concentrationIt can stimulate T cells to fight.
A certain sequence of the S protein of the new coronavirus shows the characteristics of superantigens. It deactivates T cells to fight, causing the multisystem inflammatory syndrome in children.
To sum up, the whole process can actually be understood as a virus counterattack in the human body.
The cunning virus, as an invading enemy, because of the characteristics of a super instructor, actually began to issue combat instructions to the T-cell warriors who were supposed to resist the invasion of the disease, which led to this series of reactions .
So the author proposes a hypothetical conclusion:
Acute childhood hepatitis of unknown origin is the result of adenovirus infection and intestinal malnutrition in children previously infected with SARS-CoV-2 and carrying the viral reservoir.
How should I look at the conclusions of the research hypothesis?
Although acute childhood unexplained hepatitis is the result of co-infection with adenovirus and intestinal malnutrition in children previously infected with SARS-CoV-2 and carrying the viral reservoir.
However, this study has certain limitations and should not be considered final.
On the one hand, this study and its conclusions are mainly demonstrated by an animal experiment of the interaction of adenovirus and staphylococcal enterotoxin B, so it is inherently limited.
On the other hand, there is no investigation on the combined new crown infection of other viruses, so it cannot be regarded as the final conclusion, and more investigations are still needed to prove or deny this hypothesis. .
What should we do?
Don’t panic too much for the time being, but keep an eye on this matter and be vigilant in your daily life:
In the event of jaundice, nausea, vomiting, or diarrhea, go to the doctor in time, and instruct your child to tell the teacher if he or she falls ill at school;
Whether adults or children should wash their hands carefully before meals and after using the toilet, using the seven-step handwashing method for 20 seconds;
Wear a mask when traveling;
Reduce the spread of the virus by covering your mouth and nose with your elbows and arms when you sneeze or cough.
References
[1] Epidemiological update: Hepatitis of unknown aetiology in children. 2022.
https:https://www.ecdc.europa.eu/en/news-events/epidemiological-update-hepatitis-unknown-aetiology-children
[2] Brodin P, Arditi M. Severe acute hepatitis in children: investigate SARS-CoV-2 superantigens. 2022. Lancet Gastroenterol Hepatol. doi: 10.1016/S2468-1253(22)00166 -2
[3] https:https://secure.jbs.elsevierhealth.com/action/getSharedSiteSession?redirect=https%3A%2F%2Fwww.cell.com%2Fimmunity%2Ffulltext%2FS1074 -7613%2822%2900043-7&rc=0&__cf_chl_tk=Fa_07EEccw6A._3ma0aP6SPBDK2BrxSMjlrkEmhyKJM-1652718351-0-gaNycGzNCOU#%20
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