Morphological changes in lung tissue of victims associated with the 2009 A H1N1/v09 influenza pandemic in Colombia
Keywords:
influenza A virus, H1N1 subtype, bacterial infections, pandemics, microscopy, reverse transcriptase polymerase chain reaction
Abstract
Introduction. Influenza is an acute respiratory infection that may be seasonal or pandemic. In 2009 The World Health Organization (WHO) declared an influenza pandemia; 3,876 cases and 239 deaths were reported in Colombia.
Objective. The morphological changes in lung tissues associated with virus infection H1N1/v09 were described from autopsied victims.
Materials and methods. Seventy-five cases were diagnosed by RT-PCR for influenza A H1N1/v09, of which the lungs of 20 were selected for morphological study by light microscopy, optical microscopy, high-resolution transmission electron microscopy and immunohistochemistry.
Results. Of the 75 cases, 83% had viral pneumonitis and 17% alveolitis. Complications included intra-alveolar hemorrhage (66%), edema (89%), diffuse alveolar damage (2%), and bacterial co-infection (32%). Morphological changes were as follows: destruction of the alveolar epithelium and interstitium, edema, macrophages with vacuolated cytoplasm,and infiltration of polymorphonuclear leukocytes in the alveolar lumen and interstitium, vacuolization cytoplasmic type I pneumocytes and electron-dense bodies in cellular debris in the alveolar lumen, and immunoreactivity of viral antigens in bronchiolar epithelial cells and alveolar infiltrate.
Conclusion. The low percentage of bacterial co-infection observed in these cases was a prominent feature, and suggested that the fatal result was probably not associated with secondary bacterial disease (Indicated by previous reports). The tissue lesions were attributed to tissue damage due to viral lesion, as well as the cellular and humoral inflammatory response associated with infiltration by polymorphonucleocytes and macrophages in the interstitium and alveolar lumen.
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References
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28. Rogers G, Paulson J. Receptor determinants of human and animal influenza virus isolates: Differences in receptor specificity of the H3 hemaglutinin based on species of origin. Virology. 1983;127:361-73.
29. Gagneux P, Cheriyan M, Hurtado-Ziola N, van der Linden E, Anderson D, McClure H, et al. Human-specific regulation of alpha 2-6-linked sialic acids. J Biol Chem. 2003;278:48245-50.
30. Nelli R, Kuchipudi S, White G, Perez B, Dunham S, Chang K. Comparative distribution of human and avian type sialic acid influenza receptors in the pig. BMC Vet Res. 2010;6:4.
31. Jung T, Choi C, Chae C. Localization of swine influenza virus in naturally infected pigs. Vet Pathol. 2002;39:10-6.
32. Newby C, Rowe R, Pekosz A. Influenza A virus infection of primary differentiated airway epithelial cell cultures derived from Syrian golden hamsters. Virology. 2006;354:80-90.
33. Mori I, Komatsu T, Takeuchi K, Nakakuki K, Sudo M, Kimura Y. In vivo induction of apoptosis by influenza virus. J Gen Virol. 1995;76:2869-73.
2. Michaelis M, Doerr HW, Cinatl J Jr. An influenza A H1N1 virus revival-pandemic H1N1/09 virus. Infection. 2009;37:381-9.
3. Seth J, Robert M, Walter R, Gregory A. 2009 H1N1 influenza. Mayo Clin Proc. 2010;85:64-76.
4. Craighead J. Influenza viruses. En: Craighead J, editor. Pathology and pathogenesis of human viral disease. St Louis: Burlington Books; 2000. p. 35-46.
5. Ministerio de la Protección Social, Instituto Nacional de Salud. Boletín Epidemiológico Semanal. Semana epidemiológica número 18. Bogotá, D.C.: Ministerio de la Protección Social; 2010.
6. Hinrichs S, Harrison C, Haggerty S. Viral Diseases. En: Damjanov I, Linder J, editors. Anderson's pathology..Tenth.edition. St Louis: Mosby Yearbook Inc.; 1996. p. 922-3.
7. Nicholson K, Wood J, Zambon M. Influenza. Lancet. 2003;362:1733-45.
8. Taubenberger J, Morens D. The pathology of influenza virus infections. Annu Rev Pathol. 2008;3:499-522.
9. Shieh W, Blau D, Denison A, Deleon-Carnes M, Adem P, Bhatnagar J, et al. 2009 pandemic influenza A (H1N1): Pathology and pathogenesis of 100 fatal cases in the United States. Am J Pathol. 2010;177:166-75.
10. World Health Organization. CDC protocol of real time RTPCR for swine influenza A (H1N1). Atlanta: WHO; 2009.
11. Nakajima N, Hata S, Sato Y, Tobiume M, Katano H, Kaneko K, et al. The first autopsy case of pandemic influenza (A/H1N1 pdm) virus infection in Japan: Detection of a high copy number of the virus in type II alveolar epithelial cells by pathological and virological examination. Jpn J Infect Dis. 2010;63:67-71.
12. Gill R, Sheng Z, Ely S, Guinee Jr D, Beasley M, Suh J, et al. Pulmonary pathology findings of fatal 2009 pandemic influenza A/H1N1 viral infections. Arch Pathol Lab Med. 2010;134:235-43.
13. Mauad T, Hajjar L, Callegari G, da Silva L, Schout D, Galas F. Lung pathology in fatal novel human influenza A (H1N1) infection. Am J Respir Crit Care Med. 2010;181:72-9.
14. Soto-Abraham M, Soriano-Rosas J, Díaz-Quiñónez A, Silva-Pereyra J, Vázquez-Hernández P, Torres-López O, et al. Pathological changes associated with the 2009 H1N1 virus. N Engl J Med. 2009;361:2001-3.
15. Guarner J, Paddock C, Shieh W, Packard M, Patel M, Montague J, et al. Histopathologic and immunohistochemical features of fatal influenza virus infection in children during the 2003-2004 season. Clin Infect Dis. 2006;43:132-40.
16. Guarner J, Falcón-Escobedo R. Comparison of the pathology caused by H1N1, H5N1, and H3N2 influenza viruses. Arch Med Res. 2009;40:655-61.
17. Taubenberger J, Hultin J, Morens D. Discovery and characterization of the 1918 pandemic influenza virus in historical context. Antivir Ther. 2007;12:581-91.
18. Kash J, Tumpey T, Proll S, Carter V, Perwitasari O, Thomas M, et al. Genomic analysis of increased host immune and cell death responses induced by 1918 influenza virus. Nature. 2006;443:578-81.
19. Perrone L, Plowden J, García-Sastre A, Katz J, Tumpey T. H5N1 and 1918 pandemic influenza virus infection results in early and excessive infiltration of macrophages and neutrophils in the lungs of mice. PLoS Pathog. 2008;4:e1000115.
20. Peiris J, Hui K, Yen H. Host response to influenza virus: Protection versus immunopathology. Curr Opin Immunol. 2010;22:475-81.
21. Lee K, Rhim J, Kang J. Hyperactive immune cells (T cells) may be responsible for acute lung injury in influenza virus infections: A need for early immune-modulators for severe cases. Med Hypotheses. 2011;76:64-9.
22. Seo S, Hoffmann E, Webster R. Lethal H5N1 influenza viruses escape host anti-viral cytokine responses. Nat Med. 2002;8:950-4.
23. Chan M, Cheung C, Chui W, Tsao S, Nicholls J, Chan Y, et al. Induction of pro-inflammatory cytokines in human macrophages by influenza A (H5N1) viruses: A mechanism for the unusual severity of human disease? Lancet. 2002;360:1831-7.
24. Lipatov A, Webster R. Factors determining the high pathogenicity of Hong Kong H5N1/97 influenza viruses in mammals. Inter Cong Series. 2004;1263:59-62.
25. Harford C, Hamlin A, Parker E. Electron microscopy of early citoplasmic changes due to influenza virus. J Exp Med. 1955;101:577-90.
26. Plummer M, Stone M. The pathogenensis of viral influenzal pneumonia in mice. Am J Pathol. 1964;45:95-113.
27. Stinson S, Ryan D, Hardy J, Hwang-Kow S, Loosli C. Ephitelial and surfactant changes in influenza pulmonary lesions. Arch Pathol Lab Med. 1976;100:147-53.
28. Rogers G, Paulson J. Receptor determinants of human and animal influenza virus isolates: Differences in receptor specificity of the H3 hemaglutinin based on species of origin. Virology. 1983;127:361-73.
29. Gagneux P, Cheriyan M, Hurtado-Ziola N, van der Linden E, Anderson D, McClure H, et al. Human-specific regulation of alpha 2-6-linked sialic acids. J Biol Chem. 2003;278:48245-50.
30. Nelli R, Kuchipudi S, White G, Perez B, Dunham S, Chang K. Comparative distribution of human and avian type sialic acid influenza receptors in the pig. BMC Vet Res. 2010;6:4.
31. Jung T, Choi C, Chae C. Localization of swine influenza virus in naturally infected pigs. Vet Pathol. 2002;39:10-6.
32. Newby C, Rowe R, Pekosz A. Influenza A virus infection of primary differentiated airway epithelial cell cultures derived from Syrian golden hamsters. Virology. 2006;354:80-90.
33. Mori I, Komatsu T, Takeuchi K, Nakakuki K, Sudo M, Kimura Y. In vivo induction of apoptosis by influenza virus. J Gen Virol. 1995;76:2869-73.
How to Cite
1.
Rivera J, Sarmiento L, Parra E, Toro G, Neira M, Méndez J, et al. Morphological changes in lung tissue of victims associated with the 2009 A H1N1/v09 influenza pandemic in Colombia. biomedica [Internet]. 2011 Mar. 31 [cited 2024 May 16];31(3):372-80. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/373
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