Novel insight from the first lung transplant of a COVID-19 patient.

Autor: Chen XJ; Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Pathogen Biology, Nanjing Medical University, Nanjing, China., Li K; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Xu L; Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Pathogen Biology, Nanjing Medical University, Nanjing, China., Yu YJ; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Wu B; Wuxi Lung Transplantation Center, Wuxi People's Hospital Affiliated with Nanjing Medical University, Wuxi, China., He YL; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China., Zhao WE; Analysis & Test Center, Nanjing Medical University, Nanjing, China., Li D; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Luan CX; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Hu L; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Wang J; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Ding JJ; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Yu YF; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China., Li JX; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China., Tan ZM; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China., Liu XF; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China., Wei D; Wuxi Lung Transplantation Center, Wuxi People's Hospital Affiliated with Nanjing Medical University, Wuxi, China., Zhang ZH; Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Guo XJ; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China., Su C; Department of Pathogen Biology and Immunology, Jiangsu Key Laboratory of Pathogen Biology, Nanjing Medical University, Nanjing, China., Hu ZB; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China.; Department of Epidemiology, Nanjing Medical University, Nanjing, China., Guo YS; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China., Chen JY; Wuxi Lung Transplantation Center, Wuxi People's Hospital Affiliated with Nanjing Medical University, Wuxi, China., Chen F; Department of Forensic Medicine, Nanjing Medical University, Nanjing, China.; Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2021 Jan; Vol. 51 (1), pp. e13443. Date of Electronic Publication: 2020 Nov 20.
DOI: 10.1111/eci.13443
Abstrakt: Background: To reveal detailed histopathological changes, virus distributions, immunologic properties and multi-omic features caused by SARS-CoV-2 in the explanted lungs from the world's first successful lung transplantation of a COVID-19 patient.
Materials and Methods: A total of 36 samples were collected from the lungs. Histopathological features and virus distribution were observed by optical microscope and transmission electron microscope (TEM). Immune cells were detected by flow cytometry and immunohistochemistry. Transcriptome and proteome approaches were used to investigate main biological processes involved in COVID-19-associated pulmonary fibrosis.
Results: The histopathological changes of the lung tissues were characterized by extensive pulmonary interstitial fibrosis and haemorrhage. Viral particles were observed in the cytoplasm of macrophages. CD3 + CD4 - T cells, neutrophils, NK cells, γ/δ T cells and monocytes, but not B cells, were abundant in the lungs. Higher levels of proinflammatory cytokines iNOS, IL-1β and IL-6 were in the area of mild fibrosis. Multi-omics analyses revealed a total of 126 out of 20,356 significant different transcription and 114 out of 8,493 protein expression in lung samples with mild and severe fibrosis, most of which were related to fibrosis and inflammation.
Conclusions: Our results provide novel insight that the significant neutrophil/ CD3 + CD4 - T cell/ macrophage activation leads to cytokine storm and severe fibrosis in the lungs of COVID-19 patient and may contribute to a better understanding of COVID-19 pathogenesis.
(© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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