Multiple organ infection and the pathogenesis of SARS

Journal of Experimental Medicine - Tập 202 Số 3 - Trang 415-424 - 2005
Jiang Gu1,2, Encong Gong1, Bo Zhang1, Jie Zheng1, Zifen Gao1, Yanfeng Zhong1, Wan-zhong Zou1, Jun Zhan1, Shenglan Wang1, Zhigang Xie1, Hui Zhuang3, Bingquan Wu1, Hao‐hao Zhong1, Shao Hong-quan1, Weigang Fang1, Dongshia Gao1, Fei Pei1, Xingwang Li4, Zhongpin He4, Danzhen Xu4, X SHI1, Virginia Anderson2, Anthony S.‐Y. Leong5
11Department of Pathology, Peking University, Beijing, China 100083
24State University of New York Health Science Center at Brooklyn, Brooklyn, NY 11203
32Department of Microbiology, Peking University, Beijing, China 100083
43Beijing Ditan Hospital, Beijing, China 100011
55Hunter Area Pathology Services and Discipline of Anatomical Pathology, University of Newcastle, Newcastle, Australia 2310

Tóm tắt

After >8,000 infections and >700 deaths worldwide, the pathogenesis of the new infectious disease, severe acute respiratory syndrome (SARS), remains poorly understood. We investigated 18 autopsies of patients who had suspected SARS; 8 cases were confirmed as SARS. We evaluated white blood cells from 22 confirmed SARS patients at various stages of the disease. T lymphocyte counts in 65 confirmed and 35 misdiagnosed SARS cases also were analyzed retrospectively. SARS viral particles and genomic sequence were detected in a large number of circulating lymphocytes, monocytes, and lymphoid tissues, as well as in the epithelial cells of the respiratory tract, the mucosa of the intestine, the epithelium of the renal distal tubules, the neurons of the brain, and macrophages in different organs. SARS virus seemed to be capable of infecting multiple cell types in several organs; immune cells and pulmonary epithelium were identified as the main sites of injury. A comprehensive theory of pathogenesis is proposed for SARS with immune and lung damage as key features.

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