A 26-year-old otherwise healthy man died of fulminant myocarditis. Nasopharyngeal specimens collected premortem tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Histopathological evaluation of the heart showed myocardial necrosis surrounded by cytotoxic T-cells and tissue-repair macrophages. Myocardial T-cell receptor (TCR) sequencing revealed hyper-dominant clones with highly similar sequences to TCRs that are specific for SARS-CoV-2 epitopes. SARS-CoV-2 RNA was detected in the gut, supporting a diagnosis of multisystem inflammatory syndrome in adults (MIS-A). Molecular targets of MIS-associated inflammation are not known. Our data indicate that SARS-CoV-2 antigens selected high-frequency T-cell clones that mediated fatal myocarditis.
【저자키워드】 SARS-CoV-2, myocarditis, MIS-A, T cell receptor (TCR), SARS-CoV-2 epitopes, CDR3 sequences, cd-hit, 【초록키워드】 Inflammation, Necrosis, coronavirus, macrophages, Sequencing, T-cells, Diagnosis, severe acute respiratory syndrome Coronavirus, Epitopes, myocarditis, heart, target, SARS-CoV-2 RNA, T-cell receptor, SARS-CoV-2 antigen, T-cell, respiratory, TCR, SARS-CoV-2 epitopes, SARS-CoV-2 antigens, Inflammatory, Gut, acute respiratory syndrome, myocardial necrosis, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, sequence, specimen, syndrome, clone, TCRs, selected, tested, collected, died, healthy, tissue-repair, 【제목키워드】 evidence of,