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Background: Severe clinical manifestations of multisystem inflammatory syndrome in children (MIS-C) are associated with the dysregulation of immune response following SARS-CoV-2 infection. Therefore, we analyzed the levels of 10 selected cytokines at admission to estimate disease severity and to predict the length of hospitalization. In remission samples, these mediators were followed after intravenous immunoglobulin (IVIG) treatment before discharge. Methods: Thirty-five MIS-C patients at the age of 8.4 ± 4.1 years and 11 clinical controls were included. Acute MIS-C patients were divided into two severity subgroups based on their clinical score determined by the WHO criteria. Serum concentrations of IFN-γ, IL-1α, IL-1RA, IL-8, IL-10, IL-17A, IL-18, IP-10, MCP-1, and TNF-α were measured by MILLIPLEX® Human Cytokine/Chemokine panel, while ACE2 activity was determined by a fluorescent kinetic assay. These results were correlated with routinely determined laboratory parameters and clinical characteristics. Results: MIS-C patients demonstrated significantly elevated baseline levels of most of these cytokines compared to controls. Even higher concentrations of IL-18, TNF-α and ferritin with reduced lymphocyte count were found in severe subjects with elevated clinical scores of 4–5 compared to moderate cases with a clinical score of 1–3. Furthermore, the development of cardiovascular dysfunction and prolonged hospitalization (≥8 days) were related to augmented ACE2 and IL-6 levels. IL-18, IL-1RA, IL-10 and TNF-α were diminished in response to IVIG treatment in remission samples. Finally, pre-treatment IL-18 (≥516.8 pg/mL) and TNF-α (≥74.2 pg/mL) effectively differentiated disease severity in MIS-C with AUC values of 0.770 and 0.750, respectively. Conclusions: IL-18 and TNF-α have a prognostic value in disease severity at admission and are capable of monitoring the efficacy of IVIG treatment in MIS-C. [ABSTRACT FROM AUTHOR]

Malignancies are considered as leading cause of death in parallel to cardio- and cerebrovascular diseases and their incidence is still growing from year to year. Early detection and monitoring of cancers after complex therapeutic interventions are essential for the survival of patients. In these aspects, beside radiological investigations, some lab tests play a key role, namely the tumor markers. These mostly protein-based mediators are produced in a large quantity by either cancer cells or the human body itself in response to the development of tumor. Measurement of tumor markers is usually assessed in serum samples, however, to locally detect an early malignant event, other body fluids, such as ascites, cerebrospinal fluid, or pleural effusion sample can also be analyzed. Due to the potential effects of other non-malignant conditions on the serum level of a tumor marker, the entire clinical status of investigated person needs to be considered for the correct interpretation of these results. In this review article, we summarized some important characteristics of the most widely used tumor markers.