Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure
BACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co-infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open...
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| Format: | Article |
| Language: | English |
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Elsevier España
2010-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200003 |
| _version_ | 1828308137212379136 |
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| author | Vera Luiza Capelozzi Edwin Roger Parra Manoel Ximenes Ricardo Helbert Bammann Carmen Silvia Valente Barbas Marid Irmd Seixas Duarte |
| author_facet | Vera Luiza Capelozzi Edwin Roger Parra Manoel Ximenes Ricardo Helbert Bammann Carmen Silvia Valente Barbas Marid Irmd Seixas Duarte |
| author_sort | Vera Luiza Capelozzi |
| collection | DOAJ |
| description | BACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co-infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open lung biopsy specimens from five patients with ARDS with confirmed H1N1. METHODS: Lung specimens underwent microbiologic analysis, and examination by optical and electron microscopy. Immunophenotyping was used to characterize macrophages, natural killer, T and B cells, and expression of cytokines and iNOS. RESULTS: The pathological features observed were necrotizing bronchiolitis, diffuse alveolar damage, alveolar hemorrhage and abnormal immune response. Ultrastructural analysis showed viral-like particles in all cases. CONCLUSIONS: Viral-like particles can be successfully demonstrated in lung tissue by ultrastructural examination, without confirmation of the virus by RT-PCR on nasopharyngeal aspirates. Bronchioles and epithelium, rather than endothelium, are probably the primary target of infection, and diffuse alveolar damage the consequence of the effect of airways obliteration and dysfunction on innate immunity, suggesting that treatment should be focused on epithelial repair. |
| first_indexed | 2024-04-13T15:08:58Z |
| format | Article |
| id | doaj.art-7d5b810f77ea412b94db9389859fe5d6 |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-04-13T15:08:58Z |
| publishDate | 2010-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-7d5b810f77ea412b94db9389859fe5d62022-12-22T02:42:05ZengElsevier EspañaClinics1807-59321980-53222010-01-0165121229123710.1590/S1807-59322010001200003Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failureVera Luiza CapelozziEdwin Roger ParraManoel XimenesRicardo Helbert BammannCarmen Silvia Valente BarbasMarid Irmd Seixas DuarteBACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co-infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open lung biopsy specimens from five patients with ARDS with confirmed H1N1. METHODS: Lung specimens underwent microbiologic analysis, and examination by optical and electron microscopy. Immunophenotyping was used to characterize macrophages, natural killer, T and B cells, and expression of cytokines and iNOS. RESULTS: The pathological features observed were necrotizing bronchiolitis, diffuse alveolar damage, alveolar hemorrhage and abnormal immune response. Ultrastructural analysis showed viral-like particles in all cases. CONCLUSIONS: Viral-like particles can be successfully demonstrated in lung tissue by ultrastructural examination, without confirmation of the virus by RT-PCR on nasopharyngeal aspirates. Bronchioles and epithelium, rather than endothelium, are probably the primary target of infection, and diffuse alveolar damage the consequence of the effect of airways obliteration and dysfunction on innate immunity, suggesting that treatment should be focused on epithelial repair.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200003Open lung biopsyAcute lung injuryDiffuse alveolar damageVirusElectron microscopyInnate immunity |
| spellingShingle | Vera Luiza Capelozzi Edwin Roger Parra Manoel Ximenes Ricardo Helbert Bammann Carmen Silvia Valente Barbas Marid Irmd Seixas Duarte Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure Clinics Open lung biopsy Acute lung injury Diffuse alveolar damage Virus Electron microscopy Innate immunity |
| title | Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure |
| title_full | Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure |
| title_fullStr | Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure |
| title_full_unstemmed | Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure |
| title_short | Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine-origin influenza type A/H1N1 and acute respiratory failure |
| title_sort | pathological and ultrastructural analysis of surgical lung biopsies in patients with swine origin influenza type a h1n1 and acute respiratory failure |
| topic | Open lung biopsy Acute lung injury Diffuse alveolar damage Virus Electron microscopy Innate immunity |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010001200003 |
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