Lung pathology of fatal severe acute respiratory syndrome.
Lung pathology of fatal severe acute respiratory syndrome.
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DOI：
10.1016/s0140-6736(03)13413-7
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发表时间：
2003-05-24
期刊：
影响因子：
--
通讯作者：
Peiris JS
中科院分区：
文献类型：
--
作者：
Nicholls JM;Poon LL;Lee KC;Ng WF;Lai ST;Leung CY;Chu CM;Hui PK;Mak KL;Lim W;Yan KW;Chan KH;Tsang NC;Guan Y;Yuen KY;Peiris JS
严重急性呼吸综合征（severeacuterespiratorysyndrome，SARS）是一种具有全球性影响的新型传染病。冠状病毒科的一种病毒已被确定为病因，但发病机制仍不清楚。对2003年2月和3月死于SARS的6例患者的尸检组织样本和其中1例患者的开放性肺活检进行了组织学和病毒学研究。只进行了一次完整的尸检。SARS相关冠状病毒（SARS-CoV）和人偏肺病毒感染的证据，通过逆转录PCR和血清学。病理标本进行光镜、电镜及免疫组化检查。所有6名患者都有近期感染SARS-CoV的血清学证据。弥漫性肺泡损害是常见的，但不是普遍的。形态学变化确定为支气管上皮剥脱，纤毛损失，鳞状上皮化生。1例继发性细菌性肺炎。在4名患者中观察到巨细胞浸润，肺泡和肺结节中巨噬细胞明显增加。2例患者出现噬血细胞作用。肺泡上皮细胞也表现为巨细胞，具有颗粒状的两亲性细胞质。进行全面尸检的患者脾白色髓萎缩。电子显微镜检查显示，在上皮细胞的细胞质中的病毒颗粒对应于冠状病毒。SARS与肺中的上皮细胞增殖和巨噬细胞增加有关。噬血细胞的存在支持了细胞因子失调可能至少部分导致临床疾病严重程度的论点。SARS的病例定义应该承认与这种疾病相关的肺部病理学范围。2003年5月16日在线发布http://image.thelancet.com/extras/03art4347web.pdf
Severe acute respiratory syndrome (SARS) is a novel infectious disease with global impact. A virus from the family Coronaviridae has been identified as the cause, but the pathogenesis is still unclear. Post-mortem tissue samples from six patients who died from SARS in February and March, 2003, and an open lung biopsy from one of these patients were studied by histology and virology. Only one full autopsy was done. Evidence of infection with the SARS-associated coronavirus (SARS-CoV) and human metapneumovirus was sought by reverse-transcriptase PCR and serology. Pathological samples were examined by light and electron microscopy and immunohistochemistry. All six patients had serological evidence of recent infection with SARS-CoV. Diffuse alveolar damage was common but not universal. Morphological changes identified were bronchial epithelial denudation, loss of cilia, and squamous metaplasia. Secondary bacterial pneumonia was present in one case. A giant-cell infiltrate was seen in four patients, with a pronounced increase in macrophages in the alveoli and the interstitium of the lung. Haemophagocytosis was present in two patients. The alveolar pneumocytes also showed cytomegaly with granular amphophilic cytoplasm. The patient for whom full autopsy was done had atrophy of the white pulp of the spleen. Electron microscopy revealed viral particles in the cytoplasm of epithelial cells corresponding to coronavirus. SARS is associated with epithelial-cell proliferation and an increase in macrophages in the lung. The presence of haemophagocytosis supports the contention that cytokine dysregulation may account, at least partly, for the severity of the clinical disease. The case definition of SARS should acknowledge the range of lung pathology associated with this disease. Published online May 16, 2003 http://image.thelancet.com/extras/03art4347web.pdf
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DOI：
10.1016/s0140-6736(03)13077-2
发表时间：
2003-04-19
期刊：
Lancet (London, England)
影响因子：
--
作者：
Peiris JS;Lai ST;Poon LL;Guan Y;Yam LY;Lim W;Nicholls J;Yee WK;Yan WW;Cheung MT;Cheng VC;Chan KH;Tsang DN;Yung RW;Ng TK;Yuen KY;SARS study group
通讯作者：
SARS study group
影响因子：
7.3
作者：
Lai, KN;Leung, JCK;Lan, HY
通讯作者：
Lan, HY
影响因子：
2.2
作者：
Halbur, PG;Pallarés, FJ;Paul, PS
通讯作者：
Paul, PS
影响因子：
9.4
作者：
Fouchier, RAM;Bestebroer, TM;Osterhaus, ADME
通讯作者：
Osterhaus, ADME
影响因子：
168.9
作者：
Yuen, KY;Chan, PKS;Cheng, AFB
通讯作者：
Cheng, AFB