tetano
Editor, Senior Moderator
Med Intensiva. 2011 Dec 9. [Epub ahead of print]
Lung histopathological findings in fatal pandemic influenza A (H1N1).
[Article in English, Spanish]
Nin N, S?nchez-Rodr?guez C, Ver LS, Cardinal P, Ferruelo A, Soto L, Deicas A, Campos N, Rocha O, Ceraso DH, El-Assar M, Ort?n J, Fern?ndez-Segoviano P, Esteban A, Lorente JA.
Source
Hospital Universitario de Getafe, Madrid, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
Abstract
OBJECTIVE:
To describe the lung pathological changes in influenza A (H1N1) viral pneumonia. We studied morphological changes, nitro-oxidative stress and the presence of viral proteins in lung tissue.
METHODS AND PATIENTS:
Light microscopy was used to examine lung tissue from 6 fatal cases of pandemic influenza A (H1N1) viral pneumonia. Fluorescence for oxidized dihydroethydium, nitrotyrosine, inducible NO synthase (NOS2) and human influenza A nucleoprotein (NP) (for analysis under confocal microscopy) was also studied in lung tissue specimens.
RESULTS:
Age ranged from 15 to 50 years. Three patients were women, and 5 had preexisting medical conditions. Diffuse alveolar damage (DAD) was present in 5 cases (as evidenced by hyaline membrane formation, alveolo-capillary wall thickening and PMN infiltrates), and interstitial fibrosis in one case. In the fluorescence studies there were signs of oxygen radical generation, increased NOS2 protein and protein nitration in lung tissue samples, regardless of the duration of ICU admission. Viral NP was found in lung tissue samples from three patients. Type I pneumocytes and macrophages harbored viral NP, as evidenced by confocal immunofluorescence microscopy.
CONCLUSIONS:
Lung tissue from patients with pandemic influenza A (H1N1) viral pneumonia shows histological findings consistent with DAD. Prolonged nitro-oxidative stress is present despite antiviral treatment. Viral proteins may remain in lung tissue for prolonged periods of time, lodged in macrophages and type I pneumocytes.
Copyright ? 2011 Elsevier Espa?a, S.L. and SEMICYUC. All rights reserved.
PMID:
22154847
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22154847
Lung histopathological findings in fatal pandemic influenza A (H1N1).
[Article in English, Spanish]
Nin N, S?nchez-Rodr?guez C, Ver LS, Cardinal P, Ferruelo A, Soto L, Deicas A, Campos N, Rocha O, Ceraso DH, El-Assar M, Ort?n J, Fern?ndez-Segoviano P, Esteban A, Lorente JA.
Source
Hospital Universitario de Getafe, Madrid, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
Abstract
OBJECTIVE:
To describe the lung pathological changes in influenza A (H1N1) viral pneumonia. We studied morphological changes, nitro-oxidative stress and the presence of viral proteins in lung tissue.
METHODS AND PATIENTS:
Light microscopy was used to examine lung tissue from 6 fatal cases of pandemic influenza A (H1N1) viral pneumonia. Fluorescence for oxidized dihydroethydium, nitrotyrosine, inducible NO synthase (NOS2) and human influenza A nucleoprotein (NP) (for analysis under confocal microscopy) was also studied in lung tissue specimens.
RESULTS:
Age ranged from 15 to 50 years. Three patients were women, and 5 had preexisting medical conditions. Diffuse alveolar damage (DAD) was present in 5 cases (as evidenced by hyaline membrane formation, alveolo-capillary wall thickening and PMN infiltrates), and interstitial fibrosis in one case. In the fluorescence studies there were signs of oxygen radical generation, increased NOS2 protein and protein nitration in lung tissue samples, regardless of the duration of ICU admission. Viral NP was found in lung tissue samples from three patients. Type I pneumocytes and macrophages harbored viral NP, as evidenced by confocal immunofluorescence microscopy.
CONCLUSIONS:
Lung tissue from patients with pandemic influenza A (H1N1) viral pneumonia shows histological findings consistent with DAD. Prolonged nitro-oxidative stress is present despite antiviral treatment. Viral proteins may remain in lung tissue for prolonged periods of time, lodged in macrophages and type I pneumocytes.
Copyright ? 2011 Elsevier Espa?a, S.L. and SEMICYUC. All rights reserved.
PMID:
22154847
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22154847