Zonulin as a biomarker and potential therapeutic target in multisystem inflammatory syndrome in children.

Hensley-McBain, Tiffany R; Manuzak, Jennifer A

Multisystem inflammatory syndrome in children (MIS-C) occurs during, or recently following SARS-CoV-2 infection and is characterized by persistent fever, inflammation and severe illness requiring hospitalization. The majority of MIS-C cases also present with gastrointestinal (GI) symptoms, including abdominal pain, vomiting and diarrhea. In a recent issue of the JCI, Yonker and Gilboa et al., identify zonulin as a biomarker of GI permeability in children with MIS-C, and present the results of an intriguing proof-of-concept study which suggests that zonulin may represent a potential therapeutic target for MIS-C treatment and prevention. Together, these findings suggest that intestinal mucosal dysfunction and epithelial barrier breakdown may represent a biological mechanism underlying the development of MIS-C in SARS-CoV-2-infected children.