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2024

MIP-C: An entiurely new Covid-related syndrome

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In the aftermath of the COVID-19 pandemic, medical researchers are grappling with a perplexing new syndrome. Professor Pradipta Ghosh of the University of California San Diego School of Medicine and Professor Dennis McGonagle of the University of Leeds have identified a condition they’ve dubbed MDA5-autoimmunity and Interstitial Pneumonitis Contemporaneous with COVID-19, or MIP-C for short.

The collaboration began when McGonagle noticed an uptick in cases of a rare autoimmune disease called MDA5-positive dermatomyositis among vaccinated individuals in Yorkshire, England. “He told me they were seeing mild COVID cases,” Ghosh said. “They had vaccinated around 90 percent of the Yorkshire population, but now they were seeing this very rare autoimmune disease called MDA5 — autoantibody associated dermatomyositis (DM) in patients who may or may not have contracted COVID, or even remember if they were exposed to it.”

Some patients experienced severe lung scarring and rheumatologic symptoms, with a concerning number progressing rapidly to death. “DM is more common in individuals of Asian descent, particularly Japanese and Chinese,” Ghosh said. “However, Dr. McGonagle was noting this explosive trend of cases in Caucasians.”

Harnessing the Power of Computational Medicine

To unravel this medical mystery, Ghosh and her team at the Institute for Network Medicine employed a powerful computational tool called BoNE (Boolean Network Explorer). “BoNE is designed to ignore factors that differentiate patients in a group while selectively identifying what is common (shared) across everybody in the group,” Ghosh explained.

By analyzing comprehensive medical records from the U.K.’s National Health System, they discovered that patients with the highest levels of MDA5 response also showed elevated levels of interleukin-15, a cytokine that can push immune cells to exhaustion and trigger lung fibrosis. “Interleukin-15 is a cytokine that can cause two major immune cell types,” she explained. “These can push cells to the brink of exhaustion and create an immunologic phenotype that is very, very often seen as a hallmark of progressive interstitial lung disease, or fibrosis of the lung.”

A New Syndrome Emerges

Armed with this knowledge, the researchers named the condition MIP-C, drawing a parallel to MIS-C, a separate COVID-related condition affecting children. “But this was different,” Ghosh said. “It was different in behavior and rate of progression — and in the number of deaths.”

As reports of MIP-C symptoms surface worldwide, Ghosh and McGonagle hope their identification of interleukin-15 as a causative link will spur further research into potential treatments. The global medical community must now grapple with yet another enigmatic consequence of the COVID-19 pandemic.

Keyword Phrase: MDA5-autoimmunity and interstitial pneumonitis contemporaneous with COVID-19