Immune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infection

Yuksel, M., Akturk, H. and Arikan, C. 2020. Immune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infection. European Journal of Gastroenterology and Hepatology. 32 (9), pp. 1251-1255. https://doi.org/10.1097/meg.0000000000001804

TitleImmune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infection
TypeJournal article
AuthorsYuksel, M., Akturk, H. and Arikan, C.
Abstract

Immunocompromised patients may be at increased risk to develop COVID-19 during the 2019 β-coronavirus infection. We present the unique opportunity we had to monitor the liver, IL-6 and immune cell course before, during and after COVID-19 in a boy with autoimmune hepatitis (AIH) and type 1 diabetes (T1D). CD4+ and CD8+ T cells frequencies decreased because of prednisolone, followed by a plateauing increase whereas CD19+CD20+ B cell increased strongly and was unaffected by COVID-19 infection. Moreover, the percentage of activated CD8+ T cells expressing HLA-DR (CD8+HLA-DR+) increased during COVID-19 and subsided after its clearance. Total regulatory T cells (Tregs: CD4+CD25+CD127lowFOXP3+) remained stable. Although activated Tregs (CD4+CD45RA-FOXP3high) strongly increased upon prednisolone, it decreased afterwards. Furthermore, regulatory B cells (Bregs: CD19+CD20+CD24highCD38high) declined sharply owing to prednisolone. Serum IL-6 remained undetectable at all times. We demonstrated for the first time immune monitoring in a child with AIH and T1D before, during and after COVID-19. We hypothesize that continuing with low level of prednisolone without azathioprine may have abrogated activated Tregs, Bregs and IL-6 production and therefore permitting the activation of CD8+ T cells, clearing the virus.

JournalEuropean Journal of Gastroenterology and Hepatology
Journal citation32 (9), pp. 1251-1255
ISSN1473-5687
Year2020
PublisherLippincott Williams & Wilkins
Digital Object Identifier (DOI)https://doi.org/10.1097/meg.0000000000001804
Web address (URL)http://www.scopus.com/inward/record.url?eid=2-s2.0-85089127035&partnerID=MN8TOARS
Publication dates
PublishedSep 2020

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