Simulated pathology of influenza A/H5N1

背景：暴发性急性呼吸窘迫综合征(ARDS)是甲型H5N1流感病毒感染的主要症状。甲型H5N1流感患者出现白细胞减少症。然而，细胞损伤与白细胞减少症的关系尚不清楚。方法和结果：应用宿主内数学模型，即病毒动力学和免疫反应的延迟微分方程组，来确定流感的发病机制。当白细胞破坏感染细胞时，在甲型H5N1流感病例中，白细胞破坏率变得更高。此外，利用该模型对白细胞减少症的治疗进行了比较，发现免疫球蛋白治疗比神经氨酸酶治疗更有效。结论：模拟结果表明，白细胞破坏率的增加导致了甲型H5N1流感病毒的白细胞减少和细胞损伤。此外，模拟结果表明，免疫球蛋白治疗与甲型H5N1流感相关的白细胞减少症是可能的。

Background: Fulminant acute respiratory distress syndrome (ARDS) is a major symptom of infection with influenza A/H5N1virus. Patients with influenza A/H5N1 suffer from leukopenia. Nevertheless, the association of cellular injury with leukopenia remains unclear.Methods and findings: A within-host mathematical model, a system of delay differential equations of virus dynamics and immune response, was applied to ascertain influenza pathogenesis. When leukocytes destroy infected cells, the ratio of leukocyte destruction becomes higher in the case of A/H5N1. Moreover, a comparison of therapies for leukopenia using the model reveals that immunoglobulin therapy is more effective than neuraminidase therapy.Conclusion: Simulations show that the increased ratio of destruction of leukocytes induces leukopenia and cellular injury of A/H5N1. Furthermore, results of simulations demonstrate the possibility of immunoglobulin therapy for treating leukopenia associated with influenza A/H5N1.