Clinicopathologic, Immunohistochemical, and Ultrastructural Findings of a Fatal Case of Middle East Respiratory Syndrome Coronavirus Infection in the United Arab Emirates, April 2014.
Clinicopathologic, Immunohistochemical, and Ultrastructural Findings of a Fatal Case of Middle East Respiratory Syndrome Coronavirus Infection in the United Arab Emirates, April 2014.
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2014年4月，阿拉伯联合酋长国中东呼吸道综合症冠状病毒感染的致命病例，临床病理，免疫组织化学和超微结构发现，2014年4月。
DOI：
10.1016/j.ajpath.2015.10.024
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发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
Zaki SR
中科院分区：
文献类型：
--
作者：
Ng DL;Al Hosani F;Keating MK;Gerber SI;Jones TL;Metcalfe MG;Tong S;Tao Y;Alami NN;Haynes LM;Mutei MA;Abdel-Wareth L;Uyeki TM;Swerdlow DL;Barakat M;Zaki SR
中东呼吸综合征冠状病毒（MERS-CoV）感染导致急性呼吸道疾病，并与高病死率相关；然而，严重和致命的中东呼吸综合征冠状病毒感染的发病机制尚不清楚。我们描述了世界上首次对中东呼吸综合征冠状病毒致命病例进行尸检的组织病理学、免疫组织化学和超微结构发现，该病例与2014年4月阿拉伯联合酋长国的医院爆发有关。肺组织病理主要表现为弥漫性肺泡损伤。慢性疾病的证据，包括严重的周围血管疾病、斑片状心脏纤维化和肝脂肪变性，在其他器官中也被注意到。利用抗MERS-CoV抗体与细胞角蛋白和表面活性剂的免疫组化配对进行双染色免疫分析，发现肺细胞和上皮合胞细胞是MERS-CoV抗原的重要靶点；二肽基肽酶4双免疫染色显示散在肺细胞和合胞细胞共定位。未发现肺外MERS-CoV抗原的证据，包括肾脏。这些结果为中东呼吸综合征冠状病毒在人类中的发病机制提供了重要见解。
Middle East respiratory syndrome coronavirus (MERS-CoV) infection causes an acute respiratory illness and is associated with a high case fatality rate; however, the pathogenesis of severe and fatal MERS-CoV infection is unknown. We describe the histopathologic, immunohistochemical, and ultrastructural findings from the first autopsy performed on a fatal case of MERS-CoV in the world, which was related to a hospital outbreak in the United Arab Emirates in April 2014. The main histopathologic finding in the lungs was diffuse alveolar damage. Evidence of chronic disease, including severe peripheral vascular disease, patchy cardiac fibrosis, and hepatic steatosis, was noted in the other organs. Double staining immunoassays that used anti–MERS-CoV antibodies paired with immunohistochemistry for cytokeratin and surfactant identified pneumocytes and epithelial syncytial cells as important targets of MERS-CoV antigen; double immunostaining with dipeptidyl peptidase 4 showed colocalization in scattered pneumocytes and syncytial cells. No evidence of extrapulmonary MERS-CoV antigens were detected, including the kidney. These results provide critical insights into the pathogenesis of MERS-CoV in humans.
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