Myocarditis and myopericarditis may occur after COVID-19 vaccination with an incidence of two to twenty cases per 100,000 individuals, but underlying mechanisms related to disease onset and progression remain unclear. Here, we report a case of myopericarditis following the first dose of the mRNA-1273 COVID-19 vaccine in a young man who had a history of mild COVID-19 three months before vaccination. The patient presented with chest pain, elevated troponin I level, and electrocardiogram abnormality. His endomyocardial biopsy revealed diffuse CD68 + cell infiltration. We characterized the immune profile of the patient using multiplex cytokine assay and flow cytometry analysis. Sex-matched vaccinated individuals and healthy individuals were used as controls. IL-18 and IL-27, Th1-type cytokines, were highly increased in the patient with COVID-19 vaccine-related myopericarditis compared with vaccinated controls who experienced no cardiac complications. In the patient, circulating NK cells and T cells showed an activated phenotype and mRNA profile, and monocytes expressed increased levels of IL-18 and its upstream NLRP3 inflammasome. We found that recombinant IL-18 administration into mice caused mild cardiac dysfunction and activation of NK cells and T cells in the hearts, similar to the findings in the patient with myopericarditis after COVID-19 mRNA vaccination. Collectively, myopericarditis following COVID-19 mRNA vaccination may be associated with increased IL-18-mediated immune responses and cardiotoxicity.
【저자키워드】 NK cells, NLRP3 inflammasome, Myopericarditis, interleukin 18, Th1-type immune response, COVID-19 mRNA vaccine, 【초록키워드】 COVID-19, immune response, vaccination, Cytokines, NK cell, Immune profile, cytokine, progression, monocyte, T cell, COVID-19 vaccination, mice, mRNA, Patient, Control, phenotype, Mild, incidence, troponin I, multiplex, mechanism, infiltration, administration, disease onset, chest pain, Cardiac complications, mRNA-1273 COVID-19 vaccine, dysfunction, COVID-19 mRNA Vaccination, Activation, first dose, circulating, Flow cytometry analysis, CD68, hearts, abnormality, vaccinated individual, upstream, IL-18, IL-27, controls, Cell, caused, the patient, elevated, characterized, activated, were used, occur, expressed, individuals, healthy individual, with COVID-19, 【제목키워드】 COVID-19, interleukin, mRNA, response, Increased,