Leptospirosis pulmonary haemorrhage syndrome is associated with linear deposition of immunoglobulin and complement on the alveolar surface
Leptospirosis pulmonary haemorrhage syndrome is associated with linear deposition of immunoglobulin and complement on the alveolar surface
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DOI：
10.1111/j.1469-0691.2009.02916.x
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发表时间：
2010-06-01
影响因子：
14.2
通讯作者：
Duarte, M. I. S.
中科院分区：
文献类型：
--
作者：
Croda, J.;Neto, A. N. D.;Duarte, M. I. S.
钩端螺旋体病是一种人畜共患传染病，与严重疾病如钩端螺旋体病肺出血综合征（LPHS）有关。肺出血的原因尚不清楚。了解LPHS涉及哪些机制和过程对于正在开发的针对这种危及生命的综合症的治疗方案非常重要。在本研究中，我们评估了30例LPHS患者和7个对照组的肺标本，采用组织学和免疫组化（检测IgM，IgG，伊加和C3），以描述与这种综合征的病理特征。18/30例LPHS患者的肺泡表面检测到免疫球蛋白沉积。在LPHS患者的肺组织中观察到三种免疫球蛋白和C3的染色模式：AS，肺泡表面附近的精细线性染色，这表明I型和II型肺细胞的腔表面覆盖有膜; S，沿肺泡隔沿着零星分布的不均匀染色;和IA，弱的局灶性肺泡内颗粒染色。人类LPHS与个体和独特的组织学模式相关，这些模式不同于其他肺出血原因。在本研究中，它被发现，免疫球蛋白（伊加，IgG和IgM）和补体的肺泡表面的线性沉积可能在肺出血的发病机制中发挥作用的人钩端螺旋体病。
Leptospirosis is a zoonotic infection associated with severe diseases such as leptospirosis pulmonary haemorrhage syndrome (LPHS). The cause of pulmonary haemorrhage is unclear. Understanding which mechanisms and processes are involved in LPHS will be important in treatment regimens under development for this life-threatening syndrome. In the present study, we evaluated 30 lung specimens from LPHS patients and seven controls using histology and immunohistochemistry (detection of IgM, IgG, IgA and C3) in order to describe the pathological features associated with this syndrome. Immunoglobulin deposits were detected on the alveolar surface in 18/30 LPHS patients. Three staining patterns were observed for the immunoglobulins and C3 in the lung tissues of LPHS patients: AS, delicate linear staining adjacent to the alveolar surface, which was indicative of a membrane covering the luminal surface of type I and II pneumocyte cells; S, heterogeneous staining which was sporadically distributed along the alveolar septum; and IA, weak, focal intra-alveolar granular staining. Human LPHS is associated with individual and unique histological patterns that differ from those of other causes of pulmonary haemorrhage. In the present study, it was found that the linear deposition of immunoglobulins (IgA, IgG and IgM) and complement on the alveolar surface may play a role in the pathogenesis of pulmonary haemorrhage in human leptospirosis.