What Causes PIMS?

We know that SARS-Cov-2 is the trigger for PIMS-TS, but the exact mechanics of how this works is not known. The following research papers put forward some suggestions

SARS-Cov-2 infections in children: understanding diverse outcomes
Reader.elsevier.com/reader/sd/pii/S1074761322000437 
“There is strong evolutionary pressure on young children to grow, and energy allocation trade-offs are likely to favour growth over expensive systemic inflammatory responses whenever possible. By choosing disease tolerance over maximal resistance, children are more likely to present with mild and even asymptomatic disease but might also be less efficient at viral clearance and, consequently, be more prone to some level of viral persistence and possibly other conditions linked to such viral persistence such as superantigen-mediated immune activation in MIS-C”
The article also links this to the reason for more boys than girls getting PIMS-TS
“One possibility is that an additional pathogen carrying a superantigen motif is required in conjunction with the SARS-CoV-2 infection in order to trigger MIS-C. If this pathogen is exclusive to children and young people, that could explain the lack of MIS-C among the elderly”
This is interesting as it has links to thinking by some researchers into the causes of Kawasaki Disease.

National Academy of Sciences
Very interesting, discuss whether the spike protein in SARS-Cov-2 is itself a superantigen or whether the body creates a molecule that behaves as a superantigen. Also, whether those with increased T cells are more susceptible to PIMS-TS. Covid remains in the gut. Children have been found to have elevated levels of a protein called Zonulin, which causes leaky guts, allowing the virus to circulate in the blood. They are trialling the use of a drug used for Celiac disease called Larazotide and also monoclonal antibody drugs for treatment of PIMS-TS.

NationalGeographic-super-antigens-tied-to-mysterious-covid-19-syndrome-in-children

YouTube video by Alessio Fasano on the same discussion about Covid residue in the gut
Youtube.com-AlessioFasano

and the most recent document on this subject
ScienceDaily.com/releases/2022/02/220223111247.htm

The link between Vitamin D and inflammation
Study in Covid 19 patients
Link-between-vitamin-d-and-inflammation.html

BPSU Study, Part 1
In a study of 18 PIMS-TS children (source unknown)
78% were Vitamin D deficient, 89% belonged to minority groups whose darker skin produces less Vitamin D and all children who required ICU treatment were Vitamin D deficient.

A study about the potential mechanisms involved in PIMS-TS
BMJ-archdischild-2021-323143.full.pdf

Autoimmune and inflammatory diseases following Covid 19 – molecular mechanisms, genetic predispositions etc
Nature.com/articles/s41584-020-0448-7.pdf

The role of proteins: immune protein pathways in PIMS and identifying proteins

The role of Zonulin and Caludin in PIMS

PIMS and Long Covid

Age and Ferritin levels in PIMS
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