The first autopsy case of pandemic influenza (A/H1N1pdm) virus infection in Japan: detection of a high copy number of the virus in type II alveolar epithelial cells by pathological and virological examination.
The first autopsy case of pandemic influenza (A/H1N1pdm) virus infection in Japan: detection of a high copy number of the virus in type II alveolar epithelial cells by pathological and virological examination.
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日本首例甲型H1N1pdm病毒感染尸检病例：通过病理学和病毒学检查，在II型肺泡上皮细胞中检测到高拷贝数的病毒。
DOI：
10.7883/yoken.63.67
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发表时间：
2010
影响因子：
2.2
通讯作者：
T. Sata
中科院分区：
文献类型：
--
作者：
N. Nakajima;S. Hata;Yuko Sato;M. Tobiume;H. Katano;Keiko Kaneko;N. Nagata;M. Kataoka;A. Ainai;H. Hasegawa;M. Tashiro;M. Kuroda;T. Odai;N. Urasawa;T. Ogino;Hiroaki Hanaoka;Masahide Watanabe;T. Sata
我们报告了日本2009年大流行性流感（A/H1N1pdm）病毒感染的第一例尸检病例的病理和病毒学结果。一名33岁男性，因扩张型心肌病、轻度糖尿病、特应性皮炎、支气管哮喘和肥胖导致慢性心力衰竭，死于呼吸衰竭和多器官功能障碍综合征。肉眼可见严重肺水肿，镜下肺切片显示极早期渗出性弥漫性肺泡损伤（DAD）。免疫组化显示流感病毒（A/H1N1pdm）在肺泡上皮细胞中增殖，部分病毒在细胞表面表达SAalpha2-3Gal。肺泡上皮细胞中也检测到流感病毒（A/H1N1pdm）基因组RNA和mRNA。实时荧光定量PCR结果显示，左下肺切片中分离到流感病毒（A/H1N1pdm） 723个拷贝/细胞。电镜分析显示肺组织中有丝状病毒颗粒。测定血清和肺组织中各种细胞因子/趋化因子的浓度。IL-2R、IL-6、IL-8、IL-10、ifn - α、MCP-1和MIG水平均升高。这些结果提示1例由流感（a /H1N1pdm）病毒感染引起的病毒性肺炎，表现出DAD早期的典型病理表现。
We report the pathological and virological findings of the first autopsy case of the 2009 pandemic influenza (A/H1N1pdm) virus infection in Japan. A man aged 33 years with chronic heart failure due to dilated cardiomyopathy, mild diabetes mellitus, atopic dermatitis, bronchial asthma, and obesity died of respiratory failure and multiple organ dysfunction syndrome. Macroscopic examination showed severe pulmonary edema and microscopically the lung sections showed very early exudative-stage diffuse alveolar damage (DAD). Immunohistochemistry revealed proliferation of the influenza (A/H1N1pdm) virus in alveolar epithelial cells, some of which expressed SAalpha2-3Gal on the cell surface. Influenza (A/H1N1pdm) virus genomic RNA and mRNA were also detected in alveolar epithelial cells. Real-time PCR revealed 723 copies/cell in the left lower lung section from which the influenza (A/H1N1pdm) virus was isolated. Electron microscopic analysis revealed filamentous viral particles in the lung tissue. The concentrations of various cytokines/chemokines in the serum and the autopsied lung tissue were measured. IL-2R, IL-6, IL-8, IL-10, IFN-alpha, MCP-1, and MIG levels were elevated in both. These findings indicated a case of viral pneumonia caused by influenza (A/H1N1pdm) virus infection, showing characteristic pathological findings of the early stage of DAD.