# Endothelial Cell and Cardiomyocyte Dysfunction in Children with Kawasaki disease-like SARS-CoV-2 Induced Immune Activation

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $727,650

## Abstract

Project Summary
In the wake of COVID-19 pandemic, fever with severe systemic inflammation and shock, known as Pediatric
Inflammatory Multisystem Syndrome (PIMS), has evolved as a new threat to children. PIMS was originally
reported in Western Europe and the number of cases is rapidly increasing in the U.S. A hallmark of PIMS has
been heart failure leading to shock and the absence of significant pulmonary disease. The clinical presentation
in these patients shares many features with Kawasaki disease (KD), the most common cause of acquired heart
disease in children, which itself can present with distributive shock requiring inotropic and vasoactive support in
the intensive care unit. Several PIMS patients are either SARS-CoV-2 PCR positive or have developed
antibodies against SARS-CoV-2, suggesting that PIMS is an immune-mediated reaction to antecedent exposure
to the virus. Curiously, at the same time that patients are being diagnosed with PIMS, the numbers of children
with typical KD has increased dramatically in these same regions. The emergence of PIMS is so new and so
rapidly evolving that there are literally no publications, treatment guidelines or clinical trials related to these
seriously affected pediatric patients. Through our network of 30 pediatric centers participating in KIDCARE, our
comparative effectiveness trial for treatment-resistant KD funded by PCORI, we are collecting patient data and
clinical samples to support the work proposed here. The goal of this administrative supplement is to analyze
demographic, clinical and laboratory data in conjunction with assays using patient cells and sera, which
will allow us to study the relationships among SARS-CoV-2 infection, typical KD, and PIMS and to model
different therapeutic strategies against PIMS. Three specific aims are proposed to achieve this goal. Specific
Aim 1 will profile and compare clinical features of PIMS and typical KD. Demographic and clinical data and the
neutrophil response to intravenous immunoglobulin (IVIG) will be compared between these two illnesses.
Cytokine profiles and inflammatory markers in plasma from acute and subacute PIMS and typical KD will also
be compared. Specific Aim 2 will elucidate molecular features of PIMS and compare with typical KD. We will
use RNA-seq, ELISA, and Western blot analyses to profile changes in levels of molecules related to inflammation
(e.g., TIFA, NFkβ, NLRP3-inflammasome, IL-1, IL-6, TNFα) and cardiovascular health (KLF4, miR-483, ACE2)
in endothelial cells and cardiomyocytes. Specific Aim 3 will test the efficacy of drug therapy for PIMS by
comparing the in vitro effects of intravenous immunoglobulin, steroids, and anakinra on inflammatory pathways
and cardiovascular biomarkers in endothelial cells and cardiomyocytes treated with sera from acute PIMS
patients prior to therapy. The synergistic expertise of the investigative teams in this multi-PI supplement provides
a unique opportunity to understand the clinical features, mol...

## Key facts

- **NIH application ID:** 10165329
- **Project number:** 3R01HL140898-03S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** JANE C BURNS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $727,650
- **Award type:** 3
- **Project period:** 2018-01-01 → 2021-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10165329

## Citation

> US National Institutes of Health, RePORTER application 10165329, Endothelial Cell and Cardiomyocyte Dysfunction in Children with Kawasaki disease-like SARS-CoV-2 Induced Immune Activation (3R01HL140898-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10165329. Licensed CC0.

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